Patient Financial Services Representative III

Fairview Health Services•St. Paul, MN

20d

About The Position

Fairview is hiring a Patient Financial Services (PFS) Representative III for its Revenue Cycle team. This full-time, benefit-eligible position is 1.0 FTE (80 hours per two-week pay period), works Monday through Friday for eight hours per day, and offers home-based flexibility. The role manages complex accounts receivable, insurance follow-up, and outstanding claims to support accurate and timely reimbursement, with a focus on Special Guarantor accounts and their unique payers and billing requirements. The representative researches account discrepancies, resolves denials, communicates with payers, and collaborates with internal teams. The role is responsible for billing and collecting inpatient and outpatient accounts, securing expected payment, resolving accounts, addressing complex customer service issues, and evaluating appropriate financial resources to support proper adjudication.

Requirements

Two years in a medical billing office setting or relevant experience.
Organizational skills.
Communication skills.
Attention to detail.

Nice To Haves

Two years of medical billing office setting experience.
MS Office experience.
Coordination of benefits experience.
Experience with Epic, Brightree, Billing Bridge, or comparable account software.
Experience working with medical terminology.
Experience working with CPT-4 and ICD-10.
Extensive knowledge of Fairview account review experience.
Extensive knowledge of Fairview system applications.
Extensive knowledge of Fairview Revenue Cycle Management workflows.
Billing certification.
Substantial system super-user experience.
Familiarity with Special Guarantor accounts.
Experience with professional claims billing and follow-up.

Responsibilities

Take timely and effective action to resolve financial transactions and prevent revenue shortfalls; escalate issues when appropriate.
Complete assigned work accurately and on time in accordance with productivity and quality standards, following department best practices.
Identify and provide feedback on continuous process improvements involving people and technology.
Identify opportunities to fully resolve accounts through single-touch resolution where possible.
Support collection of expected insurance or patient reimbursement and understand revenue cycle processes.
Contact payers through portals or provider service centers to facilitate timely and accurate account resolution.
Process external correspondence efficiently and promptly, and communicate and process internal correspondence clearly and professionally.
Verify insurance and patient demographics.
Understand expected payment amounts and Epic expected-payment calculations to adjust accounts appropriately.
Educate patients or guarantors about patient liability when appropriate.
Comply with applicable laws, regulations, payer requirements, and internal policies, procedures, and standards; maintain and share knowledge of them.
Process accounts through multiple workflows and handle accounts requiring additional attention to detail.
Make appropriate contacts with payers and other parties to obtain or provide information needed for timely account resolution.
Use multiple systems and applications, and knowledge of internal and external departmental workflows, to collect expected payments and expedite resolution.
Investigate and resolve complex accounts in depth.
Use public-speaking skills in discussions and meeting facilitation.
Take on complex responsibilities or projects that may require senior leadership visibility or approval.
Mentor staff or support the team lead as a key team resource.
Analyze and process correspondence in detail to improve collection processes.
Provide support in other areas of the department using extensive departmental knowledge.