Patient Financial Representative Senior - Patient Financial Services

CHRISTUS Health•Irving, TX

About The Position

The Patient Financial Representative Senior supports the CHRISTUS Health Revenue Cycle division by ensuring timely, efficient account resolution and reconciliation of outstanding patient account balances. The role works cooperatively with a team to serve internal and external customers and is expected to uphold CHRISTUS Health’s ethical standards, mission, philosophy, and core values of Dignity, Integrity, Compassion, Excellence, and Stewardship. The associate performs Revenue Cycle functions in accordance with CHRISTUS Health performance metrics and PFS quality and productivity standards. Responsibilities include gathering patient and payer information, responding to account inquiries, applying payer-specific billing and follow-up requirements, and communicating effectively to resolve outstanding questions. The role requires compliance with CHRISTUS Health, payer, and government regulations, working knowledge of CPT, HCPCS, and ICD-10 coding guidelines, and accurate documentation in patient accounting and other PFS systems. The position handles claim edits, rejected claims, billing requests, payer collections, denials, underpayments, credit balances, and account-resolution trends. It also performs cash reconciliation by ensuring payments are retrieved and posted accurately, researching unapplied cash, correcting posting errors, and reconciling receipts to bank deposits and statements. The associate provides updates to PFS leadership about errors, issues, and trends affecting productivity, reimbursement, payment delays, or patient experience.

Requirements

High school diploma or equivalent years of experience.
Strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
Professional and effective written and verbal communication skills.
Knowledge of standard bill forms and filing requirements.
Understanding of electronic claims editing and submission capabilities.

Nice To Haves

Post-high-school education preferred.
3–5 years of experience preferred.
Experience in a multi-facility hospital business office environment preferred.
Experience with inpatient and outpatient billing requirements for UB-04 and HCFA 1500 forms preferred.
College education, prior insurance-company claims experience, and/or health care billing trade-school education may be considered in lieu of formal hospital experience.

Responsibilities

Meet the 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 and PFS departmental quality and productivity standards.
Collect and provide patient and payer information to facilitate account resolution.
Respond to account inquiries through written, verbal, or electronic correspondence.
Maintain payer-specific knowledge of insurance and self-pay billing, follow-up guidelines, and third-party payer regulations.
Maintain working knowledge of functions within the Revenue Cycle.
Communicate professionally and effectively with internal and external customers to resolve outstanding account questions and meet customer expectations.
Comply with CHRISTUS Health, payer, and government regulations; apply knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
Document work appropriately in the patient accounting host system and other systems used by PFS, following policies and procedures.
Provide PFS leadership with updates about errors, issues, and trends affecting productivity, reimbursement, payment delays, and patient experience.
Review and work claim edits, payer-rejected claims for resubmission, reports, and billing requests.
Apply knowledge of standard bill forms, filing requirements, and electronic claims editing and submission capabilities.
Collect balances due from payers to ensure proper reimbursement for services.
Identify and forward account denial information to the designated departmental liaison, and work toward timely denial resolution.
Maintain knowledge of payer collection requirements and work the collector queue daily using appropriate collection systems and reports.
Identify and resolve underpayments and credit balances through appropriate follow-up within payer time limits.
Identify and communicate trends that affect account resolution.
Retrieve and post payments accurately and promptly by reconciling the patient accounting system with bank statements.
Research submitted cash payments by verifying patient account numbers and facilities.
Monitor and perform cash reconciliation to identify posting errors and ensure receipts are applied and reconciled to daily bank deposits and monthly bank statements.
Review and post cash corrections, including resolving patient complaints and inquiries from PFS, Finance, Facilities, and Vendor Partners.
Research and resolve unapplied cash through continued follow-up until the payment is identified for application or refund.