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Patient Financial Specialist
2 months ago
The Patient Financial Specialist plays a vital role in the Revenue Cycle division of CHRISTUS Health, ensuring that all processes are performed in a timely and efficient manner. This position is responsible for account resolution and reconciliation of outstanding balances for CHRISTUS Health patient accounts.
Key Responsibilities- Meet expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
- Perform Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health key performance metrics.
- Ensure PFS departmental quality and productivity standards are met.
- Collect and provide patient and payor information to facilitate account resolution.
- Maintain an active working knowledge of all Government Mandated Regulations as it pertains to claims submission.
- Respond to all types of account inquiries through written, verbal, or electronic correspondence.
- Maintain payor specific knowledge of insurance and self-pay billing and follow up guidelines and regulations for third-party payers.
- Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution.
- Meet or exceed customer expectations and requirements, and gain customer trust and respect.
- Compliant with all CHRISTUS Health, payer and government regulations.
- Exhibit a strong working knowledge of CPT, HCPCS and ICD-10 coding regulations and guidelines.
- Appropriately document patient accounting host system or other systems utilized by PFS in accordance with policy and procedures.
- Provide continuous updates and information to PFS Leadership Team regarding errors, issues, and trends related to activities affecting productivity, reimbursement, payment delays, and/or patient experience.
- Review and work claim edits.
- Work payor rejected claims for resubmission.
- Work reports and billing requests.
- Demonstrate strong knowledge of standard bill forms and filing requirements.
- Exhibit and understanding of electronic claims editing and submission capabilities.
- Correct claims in RTP status in designated claim system per Medicare guidelines.
- Maintain an active knowledge of all governmental agency requirements and updates.
- HS Diploma or equivalent years of experience required
- Post HS education preferred
- 1-3 years of experience preferred
- Experience working within a multi-facility hospital business office environment preferred.
- College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
- Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred.
- Experience with Medicare & Medicaid billing processes and regulations preferred.
- Understanding of Medicare language.
- Knowledge in locating and referencing CMS and/or Medicare Regulations preferred
