Patient Financial Specialist

2 weeks ago

Irving, United States Christus Health Full time
Description

Summary:

The associate is responsible for the duties and services that are of a support nature to the Revenue Cycle division of CHRISTUS Health. The associate ensures that all processes are performed in a timely and efficient manner. The primary purpose of these positions is to ensure account resolution and reconciliation of outstanding balances for CHRISTUS Health patient accounts. The position works in a cooperative team environment to provide value to internal and external customers.

The associate carries out his/her duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of CHRISTUS Health, and fully supports CHRISTUS Health's Mission, Philosophy, and core values of Dignity, Integrity, Compassion, Excellence and Stewardship.

Responsibilities:

  • Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
  • Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics.
  • Ensures PFS departmental quality and productivity standards are met.
  • Collects and provides patient and payor information to facilitate account resolution.
  • Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission. Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission.
  • Responds to all types of account inquires through written, verbal, or electronic correspondence.
  • Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers. Maintains working knowledge of all functions within the Revenue Cycle.
  • Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution.
  • Meets or exceeds customer expectations and requirements, and gains customer trust and respect.
  • Compliant with all CHRISTUS Health, payer, and government regulations.
  • Exhibits a strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
  • Appropriately documents patient accounting host system or other systems utilized by PFS in accordance with policy and procedures.
  • Provide continuous updates and information to the PFS Leadership Team regarding errors, issues, and trends related to activities affecting productivity, reimbursement, payment delays, and/or patient experience.
  • Professional and effective written and verbal communication required.

Billing

  • Review and work on claim edits.
  • Works payor rejected claims for resubmission.
  • Works reports and billing requests.
  • Demonstrates strong knowledge of standard bill forms and filing requirements.
  • Exhibits and understanding of electronic claims editing and submission capabilities.
  • Correct claims in RTP status in the designated claim system per Medicare guidelines.
  • Maintains an active knowledge of all governmental agency requirements and updates.

Collections

  • Collect balances due from payors ensuring proper reimbursement for all services.
  • Identifies and forwards proper account denial information to the designated departmental liaison. Dedicated efforts to ensure a proper denial resolution and timely turnaround.
  • Maintain an active knowledge of all governmental agency requirements and updates.
  • Works collector queue daily utilizing appropriate collection system and reports.
  • Demonstrates knowledge of standard bill forms and filing requirements.
  • Identify and resolve underpayments with the appropriate follow-up activities within payor timely guidelines.
  • Identify and resolve credit balances with the appropriate follow-up activities within payor timely guidelines.
  • Identify and communicate trends impacting account resolution.
  • Corrects claims in RTP status in the designated claim system per Medicare guidelines.
  • Initiates Medicare Redetermination, Reopening and/or Reconsideration as needed.
  • Working knowledge of the CMS 838 credit balance report.

Vendor Coordinator

  • Acts as liaison between external vendors and Revenue Cycle departments to monitor external vendor activities and ensures accounts placed for collection are received timely and acknowledged as received by the vendor.
  • Manages account transfers between CHRISTUS Health and the various contracted vendors.
  • Coordinates with Revenue Cycle Managers (Collections, Billing, Cash Applications, etc.) to review of selected accounts prior to transfer and placement with an external third party.
  • Ensures accounts deemed as closed or uncollectible by the vendors are properly reflected in applicable AR systems.
  • Maintains department reports measuring agency performance, which includes account placements, collections, returns, and performance metrics.
  • Advises vendors of CHRISTUS Health billing and collection procedures and ensures accounts identified with third-party coverage are properly billed by the entities as requested by the vendor.
  • Audits all vendor remittances and ensures all fees billed to CHRISTUS Health are in accordance with the contract and include supporting documentation of payments posted to the account on the patient accounting systems.
  • Recalls accounts incorrectly placed and/or as requested by Revenue Cycle Managers with the external vendor and returns accounts to open receivables as appropriate.
  • Creates tools, reports, or documentation that enables Revenue Cycle Leadership to understand, manage, and measure their vendor's performance and to prioritize important relationships.
  • Performs account reconciliation between CHRISTUS Health system and vendor system.

Requirements:

  • 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.

Work Type:

Full Time


EEO is the law -

  • Patient Financial Specialist

    2 weeks ago

    Irving, United States Catapult Staffing Full time

    Job Title: Patient Financial Specialist Job Summary: The Patient Financial Specialist is responsible for providing support to High Performance Work Teams by ensuring timely and efficient processes. Duties include cash posting, customer service, data entry, and reviewing claims for proper billing and collections. This role also involves performing billing,...

  • Patient Financial Specialist

    5 days ago

    Irving, United States Catapult Solutions Group Full time

    Job DescriptionJob DescriptionJob Title: Patient Financial SpecialistJob Summary: The Patient Financial Specialist is responsible for providing support to High Performance Work Teams by ensuring timely and efficient processes. Duties include cash posting, customer service, data entry, and reviewing claims for proper billing and collections. This role also...

  • Patient Financial Specialist

    4 weeks ago

    Irving, United States Catapult Solutions Group Full time

    Job DescriptionJob DescriptionJob Title: Patient Financial SpecialistJob Summary: The Patient Financial Specialist is responsible for providing support to High Performance Work Teams by ensuring timely and efficient processes. Duties include cash posting, customer service, data entry, and reviewing claims for proper billing and collections. This role also...

  • Patient Financial Specialist Lead

    1 month ago

    Irving, Texas, United States CHRISTUS Health Full time

    Summary:The Patient Financial Specialist Lead must demonstrate a consistently high degree of proficiency in their primary position within Patient Financial Services Department of CHRISTUS Health. The Team Lead is responsible for a variety of activities in the department. The primary purpose of this position is to allow for professional growth and development...

  • Patient Financial Specialist

    4 weeks ago

    Irving, United States Christus Health Full time

    **Summary**: Responsible for the duties and services that are of a support nature to the RCBS High Performance Work Teams. Ensures that all processes are performed in a timely and efficient manner. Performs assigned duties such as, cash posting, customer service, data entry and reviewing of claims for proper billing/collections. Responsible for performing...

  • Specialist, Patient Collections

    1 month ago

    Irving, United States Pacific Dental Services Full time

    Now is the time to join Pacific Dental Services. You will have opportunities to learn new skills from our team of experienced professionals. If you're ready to take your career to the next level and gain valuable experience, apply today! Under the direction of the Mgr, Collections, the Specialist, Patient Collections will advise customers of necessary...

  • Patient Services Specialist

    5 days ago

    Irving, United States Prestige Staffing Full time

    Patient Services Specialist for Baylor Scott & White Health in Irving, TX 75063 Pay Range: $17 - $22/hr. W2 Onsite at 400 W I-635, Irving, TX 75063 M-F 8AM - 5PM Candidates must live close by Las Colinas/Irving Area Work Schedule: Mon-Fri 8a-5p (not flexible) Top Skills: Epic exp preferred, good customer service skills, pediatric exp highly...

  • Patient Services Specialist

    2 weeks ago

    Irving, United States Prestige Staffing Full time

    Patient Services Specialist for Baylor Scott & White Health in Irving, TX 75063 Pay Range: $17 - $22/hr. W2 Onsite at 400 W I-635, Irving, TX 75063 M-F 8AM - 5PM Candidates must live close by Las Colinas/Irving Area Work Schedule: Mon-Fri 8a-5p (not flexible) Top Skills: Epic exp preferred, good customer service...

  • Patient Financial Specialist

    2 weeks ago

    Irving, Texas, United States Christus Health Full time

    Summary:Responsible for the duties and services that are of asupport nature to the RCBS High Performance Work Teams. Ensuresthat all processes are performed in a timely and efficient manner.Performs assigned duties such as, cash posting, customer service,data entry and reviewing of claims for proper billing/collections.Responsible for performing billing,...

  • Patient Financial Representative

    4 weeks ago

    Irving, United States Vezita Healthcare Inc DBA - Vezita Consulting Full time

    Job DescriptionJob DescriptionPosition: Patient Financial Representative Facility: Christus System Office Campus: irving, TX Duration: 3 months contract (Temp to Perm) Pay Rate: $22/hr. Shift: 8:00 AM - 5:00 PM

  • Submission for the position: Patient Services Specialist

    3 weeks ago

    Irving, United States Baylor Scott & White Healthcare Full time

    JOB SUMMARYThe Patient Services Specialist 1, with direct oversight, provides administrative support in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care. Duties include patient relations, check-in and check-out, scheduling, insurance verification and answering phones.ESSENTIAL FUNCTIONS...

  • Submission for the position: Patient Services Specialist

    2 weeks ago

    Irving, Texas, United States Baylor Scott & White Healthcare Full time

    JOB SUMMARYThe Patient Services Specialist 1, with direct oversight, provides administrative support in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care. Duties include patient relations, check-in and check-out, scheduling, insurance verification and answering phones.ESSENTIAL FUNCTIONS...

  • Director Patient Financial Services

    1 month ago

    Irving, United States Christus Health Full time

    DescriptionSummary:Responsible for providing leadership, support, direction, and focus for Patient Financial Services Managers and Associates. Accountable for achieving Revenue Cycle goals of 93% 120 days net to cash or above and adjustment rate after 30-120 at or below 8%. Supports the overall objective of 96% 120 days net to cash. Serves as a resource for...

  • Director Patient Financial Services

    3 weeks ago

    Irving, United States Christus Health Full time

    DescriptionSummary:Responsible for providing leadership, support, direction, and focus for Patient Financial Services Managers and Associates. Accountable for achieving Revenue Cycle goals of 93% 120 days net to cash or above and adjustment rate after 30-120 at or below 8%. Supports the overall objective of 96% 120 days net to cash. Serves as a resource for...

  • Patient Financial Representative

    4 weeks ago

    Irving, United States Vezita Healthcare Inc DBA - Vezita Consulting Full time

    Job DescriptionJob DescriptionPosition: Patient Financial Representative Facility: Christus Campus: Irving, TX, 75038 Duration: 3 months contract Pay Rate: $25/hr. Shift: 8:00 AM - 5:00 PM SUMMARY: Responsible for the duties and services that are of a support nature to the RCBS High Performance Work Teams. Ensures that all processes are performed in a timely...

  • Patient Financial Representative

    4 weeks ago

    Irving, United States Anveta Health Inc Full time

    **Patient Financial Representative Senior** Location**:Irving, TX** Shift**:Monday-Friday 8 hours** Duration: 13 Weeks Contract position **Hospital collections, reimbursement, denials, insurance are a must have for this role** **Job Summary**: The associate is responsible for the duties and services that are of a support nature to the Revenue Cycle...

  • Sales Specialist

    2 weeks ago

    Irving, Texas, United States David Francesangelo Financial Services Full time

    Company DescriptionInsurance and Financial Services Position- State Farm Agent Team MemberRole DescriptionBe apart of a new and thriving team that grows together, personally and professionally. Enjoy a rewarding experience from helping to protect customers and the community from everyday risks. This is an exciting growth opportunity to work in a dynamic...

  • Patient Financial Representative

    4 weeks ago

    Irving, United States Enterprise Solution Inc. Full time

    Roles & Responsibilities This position is a back up for business office functions, providing work coverage for the various operational work units in the RCBS organization. This includes billing, collections, reimbursement validation, cash posting, mail handling, scanning, sorting, assembly, copying, faxing, and data entry functions. In addition, this...

  • Patient Service Specialist

    3 days ago

    Irving, United States ADASTAFF Medical Full time

    Job DescriptionJob DescriptionWe are excited to invite a dedicated and experienced Patient Services Representative to join our dynamic healthcare team in Fort Worth, TX. **JOB SUMMARY**As a Patient Services Representative, you will be the first point of contact for our patients, ensuring a seamless and efficient front desk operation. Your responsibilities...

  • Patient Financial Representative Senior

    4 weeks ago

    Irving, United States Verdant Infotech Solutions Full time

    Patient Financial Representative Senior client: Christus Health Visa: USC and GC Rate: $20.05/hr Duration: 3 months Location: Irving, TX, 75038 ( Need Local of Irving) (Onsite) Interview: Call/Video Job Description: Summary Patient Financial Representative Senior- Onsite Monday-Friday 8 hours Healthcare exp is a must. Hospital billing, collections, claims...