Patient Financial Services Representative - Patient Financial Services SVHC - FT - Day

Stormont-Vail HealthCare•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 compliance with JCAHO, Medicare, Payer contracts, HIPAA, regulatory agencies, and the organization's Code of Conduct.

Requirements

High School Diploma / GED Required
1 year Experience in healthcare financial services, patient registration, patient scheduling, or claims processing experience in the liability insurance field. Required
Excellent interpersonal and communication skills and the ability to exhibit patience.
Detailed knowledge of major third-party billing and contract.
Working knowledge of basic medical terminology.
Ability to work productively as part of a team.
Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or government regulations.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages.
Ability to apply concepts of basic Algebra.

Nice To Haves

Associate's Degree Preferred

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 remaining bill edit failures, claim submission, receipt reconciliation, and rebilling when necessary.
Collecting, validating, and updating patient’s 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.
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.
Accurately and efficiently distributing and/or preparing various reports; processing account credit balances, refund requests, cash transfers, returned checks, and unidentified payments in a timely manner.
Accurately posting payments and adjustments and balancing all entries according to payer cash processing and reconciliation procedures.
Answering questions from other staff or clinic offices by phone or e-mail in a timely manner.
Consistently and accurately documenting accounts with activities as needed in a timely manner.
Analyzing and resolving insurance correspondence for unpaid claims.
Validating accuracy of insurance information and completed insurance verification for specific payors that do not participate in electronic eligibility by established procedures (phone calls, websites, etc.).
Completing manual billing process for claims that cannot be sent electronically.
Creating encounters for Physicians providing Hospital professional services including but not limited to ED professional fees, Hospital visits, Invasive procedures, Hospitalists, Radiologists, Therapies (including Chemo & Radiation), Counseling, etc.
Generating re-bills after all edits have been resolved and re-submitting claims to third-party payor.
Identifying and correctly resolving all electronic claim edits failures in a timely manner.
Identifying missing or incorrect requirements of rejected claims and either resolving or forwarding promptly to appropriate staff for resolution.
Monitoring and completing patient accounts on billing hold for additional information within ten business days.
Reviewing and resolving unbilled encounter report.
Reviewing Hospital cards/interface charges/electronic charge sheets, etc. for accuracy and resolving missing/incorrect information as necessary.
Reviewing Posting & Exception Reports and verifying that information has been accurately recorded on the account receivable system.
Complying with all policies, standards, mandatory training and requirements of Stormont Vail Health.
Performing other duties as assigned.