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Patient Financial Representative Senior
2 months ago
The Patient Financial Representative Senior plays a vital role in ensuring the efficient and timely resolution of patient accounts at CHRISTUS Health. This position requires a strong understanding of revenue cycle functions and the ability to work effectively in a team environment to provide excellent customer service.
Key Responsibilities- Perform revenue cycle functions in accordance with CHRISTUS Health's key performance metrics.
- Ensure the PFS department meets quality and productivity standards.
- Collect and provide patient and payor information to facilitate account resolution.
- Respond to account inquiries through written, verbal, or electronic correspondence.
- Maintain knowledge of payor-specific insurance and self-pay billing guidelines and regulations.
- Responsible for professional and effective communication with internal and external customers to resolve outstanding questions.
- 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.
- 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 understanding of electronic claims editing and submission capabilities.
- Collect balances due from payors ensuring proper reimbursement for all services.
- Identify and forward proper account denial information to the designated departmental liaison.
- Maintain active knowledge of all collection requirements by payors.
- Work collector queue daily utilizing appropriate collection system and reports.
- Demonstrate knowledge of standard bill forms and filing requirements.
- Identify and resolve underpayments with follow-up activities within payor timely guidelines.
- Identify and resolve credit balances with follow-up activities within payor timely guidelines.
- Identify and communicate trends impacting account resolution.
- Prefer minimum of 2 years' experience with insurance billing, collections, payment, and reimbursement verification and/or refunds.
- Professional and effective written and verbal communication required.
- Experience working within a multi-facility hospital business office environment preferred.
- College education, previous insurance company claims experience, and/or healthcare 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.
