Lead Patient Financial Services Representative - Patient Financial Services - FT - Day

Stormont Vail Health•Topeka, KS

1d•Remote

About The Position

The Patient Financial Services Representative is responsible for ensuring efficient, accurate, and timely processing of patient accounts. This includes uploading applications, service registration, and final third-party payment account resolution for automobile, workers compensation, and liability patient accounts. These activities are performed in accordance with established policies and procedures, and in compliance with JCAHO, Medicare, Payer contracts, HIPAA, regulatory agencies, and the organization's Code of Conduct.

Requirements

High School Diploma / GED Required
1 year Healthcare financial services, healthcare registration services or related healthcare experience. Required
Working knowledge of basic medical terminology. (Required proficiency)
Detailed knowledge of major third-party billing and contract requirements required. (Required proficiency)
Excellent customer service skills. (Required proficiency)
Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or government regulations. (Required proficiency)
Ability to communicate clearly both verbally and in writing.
Ability to effectively present information and respond to questions from management, physicians, employees and the general public. (Required proficiency)
Ability to make some independent decisions regarding work prioritization, coordination, application of departmental procedures and routine customer service issues.
Ability to define problems, collect data, establish facts, and draw valid conclusions. (Required proficiency)

Responsibilities

Processing of patient accounts after initial bill submission to final 3rd party payment resolution, including timely and accurate resolution of denied claims and insurance correspondence, and follow-up on unpaid claims exceeding the clean claim payment cycle.
Processing patient accounts from uploading into the clearinghouse application through final claim submission, both manual and electronic, including resolving bill edit failures, claims submission, receipt of reconciliation, and rebilling when necessary.
Following cash receipting and balancing processing procedures with accuracy and efficiency.
Collecting, validating, and updating patients comprehensive data set and documenting in the registration system.
Completing electronic insurance verifications, identifying managed care issues and referring as appropriate for resolution.
Obtaining appropriate signatures to satisfy legal and health system requirements and completion of required forms including Medicare MSP.
Researching and accurately resolving accounts in a timely manner.
Thoroughly researching and resolving any noted payment discrepancies in a timely manner.
Accurately posting payments and adjustments and balancing all entries according to payer cash processing and reconciliation procedures.
Accurately and efficiently processing cash transfer according to established procedure.
Accurately and efficiently processing account credit balances and processing refund requests in a timely manner.
Accurately and efficiently processing unidentified payments and unapplied activity accounts in a timely manner.
Understanding technical primary and secondary billing requirements for assigned third party payers and contracts.
Consistently and accurately documenting accounts with activities as needed in a timely manner.
Identifying and notifying management of customer service issues and potential process/system problems that cause billing and payment errors and assisting in improvement implementation as requested.
Reading and comprehending correspondence from government and third-party payers to keep abreast of new regulations, policies, and billing and payment requirements.
Assisting with the revision or development of the department's internal documents, procedural manuals, and forms, as requested.
Answering questions from other staff or clinic offices by phone or e-mail in a timely manner.
Complying with all policies, standards, mandatory training, and requirements of Stormont Vail Health.
Performing other duties as assigned.