About the position
The associate is responsible for the duties and services that are of a support nature to the Revenue Cycle division of CHRISTUS Health. The associate ensures that all processes are performed in a timely and efficient manner. The primary purpose of these positions is to ensure account resolution and reconciliation of outstanding balances for CHRISTUS Health patient accounts. The Job works in a cooperative team environment to provide value to internal and external customers. The associate carries out his/her duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of CHRISTUS Health, and fully supports CHRISTUS Health's Mission, Philosophy, and core values of Dignity, Integrity, Compassion, Excellence and Stewardship.
Responsibilities
- Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
- Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics.
- Ensures PFS departmental quality and productivity standards are met.
- Collects and provides patient and payor information to facilitate account resolution.
- Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission.
- Responds to all types of account inquiries through written, verbal, or electronic correspondence.
- Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers.
- Responsible for professional and effective written and verbal communication with both internal and external customers.
- Meets or exceeds customer expectations and requirements, and gains customer trust and respect.
- Compliant with all CHRISTUS Health, payer, and government regulations.
- Exhibits a strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
- Appropriately documents patient accounting host system or other systems utilized by PFS in accordance with policy and procedures.
- Provide continuous updates and information to the PFS Leadership Team regarding errors, issues, and trends related to activities affecting productivity, reimbursement, payment delays, and/or patient experience.
- Demonstrates strong knowledge of standard bill forms and filing requirements.
- Works payor rejected claims for resubmission.
- Collect balances due from payors ensuring proper reimbursement for all services.
- Acts as liaison between external vendors and Revenue Cycle departments to monitor external vendor activities.
Requirements
- HS Diploma or equivalent years of experience required.
- 1-3 years of experience preferred.
- Experience working within a multi-facility hospital business office environment preferred.
- Experience with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred.
- Experience with Medicare & Medicaid billing processes and regulations preferred.
- Understanding of Medicare language.
- Knowledge in locating and referencing CMS and/or Medicare Regulations preferred.
Nice-to-haves
- Post HS education preferred.
- College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience.
