Patient Financial Services Representative

Lifepoint Health • Franklin, TN

7d • Remote

About The Position

A Patient Financial Services Representative is responsible for completing insurance claims for patient services, follow-up on the claims to ensure payment is made promptly and accurately. Ensure Medicare rejections from IVANS are worked daily and rekeyed via DDE system. Maintains knowledge of CMS billing rules and regulations. Responsible for complex billing issues. Manage Medicare Bad Debt Log. Manage Patient Financial Services Denial Log. Responsible for primary Medicare First Level Appeal Submission after approval from PFSD.

Requirements

• High School diploma or equivalent required
• Minimum of 4 years in Insurance Billing/Follow up required
• You must be authorized to work in the United States without employer sponsorship.

Nice To Haves

• Associate’s degree or higher preferred
• Coding experience preferred

Responsibilities

• Ensures the collection of funds for all hospital billable services so that goals are met in Bad Debts, AR Days and Cash collections
• Supports the Director of Patient Accounting to maximize the income earned through cash management
• Maintains accuracy in claims processing paper and electronic claims
• Maintains follow-up on accounts to ensure claims are paid promptly and correctly
• Explains patient inquiries regarding hospital charges, insurance payments or insurance coverage
• Develops a relationship with third party payers, and venders to ensure cash flow is maximized
• Inquires and seeks explanations for all denials and/or rejections
• Adheres to standards set forth by Health Insurance Portability and Accountability Act (HIPAA) of 1996
• Ensures Medicare rejections from IVANS are worked daily and rekeyed via DDE system
• Maintains knowledge of CMS billing rules and regulations
• Be responsible for complex billing issues
• Managed Medicare Bad Debt Log for Monthly submission: Reviews Medicaid remits daily for Medicare qualifying accounts and PFSD will give agency returns for account review of accounts > 120 for logging
• Manages Patient Financial Services Denial Log
• Be responsible for primary Medicare First Level Appeal Submission after approval from PFSD

Benefits

• Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Ongoing learning and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED