Patient Financial Representative Senior - Patient Financial Services HB

CHRISTUS Health•San Antonio, TX

About The Position

The Patient Financial Representative Senior supports the CHRISTUS Health Revenue Cycle division by ensuring patient account balances are resolved and reconciled in a timely and efficient manner. 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 performance, quality, productivity, customer service, and regulatory requirements. Responsibilities span billing, collections, account follow-up, and cash reconciliation. The role requires effective written and verbal communication, working knowledge of payer requirements and billing guidelines, and appropriate documentation in patient accounting and other systems.

Requirements

High school diploma or equivalent years of experience.
Professional and effective written and verbal communication skills.
Strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.

Nice To Haves

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

Responsibilities

Meet the expectations of 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 performance metrics and 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 knowledge of payer-specific insurance and self-pay billing and follow-up guidelines and regulations, as well as all Revenue Cycle functions.
Communicate professionally and effectively with internal and external customers to resolve account questions and outstanding balances.
Comply with CHRISTUS Health, payer, and government regulations, and apply CPT, HCPCS, and ICD-10 coding regulations and guidelines.
Document activity appropriately in the patient accounting host system and other PFS systems, in accordance with policies and procedures.
Provide PFS leadership with updates on errors, issues, and trends affecting productivity, reimbursement, payment delays, or patient experience.
Review and work claim edits, payer-rejected claims for resubmission, reports, and billing requests.
Apply knowledge of standard bill forms and filing requirements and electronic claims editing and submission capabilities.
Collect payer balances and ensure appropriate reimbursement for services.
Identify and forward denial information to the designated departmental liaison, and pursue timely denial resolution.
Work the collector queue daily using appropriate collection systems and reports, and follow payer collection requirements.
Identify and resolve underpayments and credit balances through appropriate follow-up within payer time limits.
Identify and communicate trends affecting account resolution.
Retrieve and post payments accurately and promptly, reconciling patient accounting records with bank statements.
Research cash payments by verifying patient account numbers and facilities.
Monitor and perform cash reconciliation, identify cash posting errors, and reconcile receipts 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 payments are identified for application or refund.