PFS Representative CBO Ambulatory Billing Follow-up Medicare

Banner Health • Greeley, CO

2d • $18 - $27 • Remote

About The Position

The PFS Insurance Follow-Up Representative (Ambulatory Denials, Medicare team) is responsible for following up with assigned payer for various denials, such as no authorization, eligibility denials, etc. This position is a higher-level PFS role, as it does range across all groups of patients and all types of provider specialties, as well as the full cycle of claim, from initial billing to zero balance. Experience with medical insurance AR and physician fee-for-service billing is ideal and knowledge of Medicare, Medicare Advantage, Medicaid, and Commercial insurance is highly preferred. Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care. POSITION SUMMARY This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner.

Requirements

• High school diploma/GED or equivalent working knowledge.
• Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience.
• Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently.
• Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences.
• Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.

Nice To Haves

• Work experience with the Company’s systems and processes is preferred.
• Previous cash collections experience is preferred.
• Additional related education and/or experience preferred.

Responsibilities

• May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing.
• As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement.
• May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary.
• Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients.
• Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.
• Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
• Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
• Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner.

What This Job Offers

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