Patient Financial Services Representative III

Fairview Health Services • St. Paul, MN

13d

About The Position

This position is responsible for billing and collecting accounts receivable for inpatient and outpatient accounts, ensuring expected payment is collected and accounts are fully resolved, and resolving complex customer service issues. The role evaluates and secures appropriate financial resources for patients to support proper adjudication.

For coding and charging, the representative codes runs from patient care reports (PCRs) and adds appropriate charges. The role manages MHealth Fairview EMS balances in the ImageTrend/Billing Bridge system and develops an in-depth understanding of ambulance and MedKab billing processes and functions needed to resolve accounts. It also handles timely processing and follow-up of patient requests for coding and charging reviews and independently helps patients resolve account issues.

The representative processes accounts through multiple workflows, investigates and resolves complex accounts, and supports the team through mentoring and assistance to the lead. The position may also take on complex responsibilities or projects requiring senior leadership visibility or approval.

Requirements

• At least 2 years in a medical billing office setting or relevant experience.
• Organizational skills.
• Communication skills.
• Attention to detail.
• Certified Ambulance Coder (CAC) certification must be obtained within 9 months of hire for the coder position.

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 with medical terminology.
• Experience 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 (RCM) workflows.
• Billing certification.
• Substantial system super-user experience.
• Ambulance billing, follow-up, verification, or coding experience.
• Knowledge of ImageTrend Billing Bridge software.

Responsibilities

• Resolve financial transactions promptly and effectively to prevent revenue shortfalls and collect expected payments; escalate issues when appropriate.
• Complete daily assignments accurately and on time in accordance with organizational productivity and quality standards.
• Follow department best-practice routines and guidelines.
• Identify and communicate process improvements involving people and technology through tracking and trending.
• Seek single-touch resolution where possible to fully resolve accounts.
• Evaluate and secure appropriate reimbursement from insurers or patients.
• Contact payers through portals or provider service centers to resolve accounts accurately and promptly.
• Process external correspondence efficiently and on time; communicate and process internal correspondence clearly, professionally, and promptly.
• Verify insurance and/or patient demographics.
• Understand expected payment amounts and Epic expected-payment calculations and adjust accounts appropriately.
• Educate patients and guarantors about patient liability when appropriate.
• Comply with applicable laws, regulations, payer requirements, and internal policies, procedures, and standards.
• Process accounts through multiple workflows and handle accounts requiring additional attention to detail.
• Contact payers and other parties to obtain or provide information needed for timely, accurate account resolution.
• Use multiple systems and applications to support collection of expected payments.
• Use knowledge of internal and external departmental functions and workflows to expedite account 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 and/or support the team lead.
• Analyze and process correspondence in detail to improve collection processes.
• Maintain and share knowledge of applicable laws, regulations, payer requirements, and internal policies, procedures, and standards.
• Provide support as needed using extensive knowledge of other areas within the department.
• Code runs from patient care reports and add appropriate charges.
• Manage MHealth Fairview EMS balances in ImageTrend/Billing Bridge and apply knowledge of ambulance and MedKab billing processes.
• Process and follow up on patient requests for coding and charging review.
• Work independently to resolve patient account issues.

Benefits

• Medical plans.
• Dental plans.
• Vision plans.
• Life insurance.
• Short-term disability insurance.
• Long-term disability insurance.
• PTO and Sick and Safe Time.
• Tuition reimbursement.
• Retirement benefits.
• Early access to earned wages.
• Other benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed