Lead Patient Financial Services Representative - Patient Financial Services - FT - Day

Position Status:

Full time

Shift:

First Shift (Days - Less than 12 hours per shift) (United States of America)

Hours per week:

40

Job Information
Exemption Status: Non-Exempt

A Brief Overview
Patient Financial Services Representative is responsible for ensuring efficient, accurate and timely processing patient accounts, uploading applications, service registration and final third- party payment account resolution after initial bill submission for automobile, workers compensation and liability patient accounts. These activities are completed following established policies and procedures, and in compliance with JCAHO, Medicare, Payer contracts, HIPAA, regulatory agencies and the organization's Code of Conduct.

Education Qualifications

• High School Diploma / GED Required

Experience Qualifications

• 1 year Healthcare financial services, healthcare registration services or related healthcare experience. Required

Skills and Abilities

• Working knowledge of basic medical terminology. (Required proficiency)
• Detailed knowledge of major third-party billing and contract requirements required. (Required proficiency)
• Excellent customer service skills. (Required proficiency)
• Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or government regulations. (Required proficiency)
• Ability to communicate clearly both verbally and in writing. Ability to effectively present information and respond to questions from management, physicians, employees and the general public. (Required proficiency)
• Ability to make some independent decisions regarding work prioritization, coordination, application of departmental procedures and routine customer service issues. Ability to define problems, collect data, establish facts, and draw valid conclusions. (Required proficiency)

What you will do

• Responsible for the processing of patient accounts after initial bill submission to final 3rd party payment resolution. This responsibility includes timely and accurate resolution of denied claims and insurance correspondence and follow-up on unpaid claims exceeding the clean claim payment cycle.
• Process patient accounts from uploading into the clearinghouse application through final claim submission, both manual and electronic. This responsibility includes resolving remaining bill edit failures, claims submission, receipt of reconciliation and rebilling when necessary.
• Follows cash receipting and balancing processing procedures with accuracy and efficiency.
• Collects, validates, and updates patients comprehensive data set and documenting in 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.
• Researches and accurately resolves accounts in a timely manner.
• Thoroughly researches and resolves any noted payment discrepancies in a timely manner.
• Accurately posts payments and adjustments and balances all entries according to payer cash processing and reconciliation procedures.
• Accurately and efficiently processes cash transfer according to established procedure.
• Accurately and efficiently processes account credit balances and processes refund requests in a timely manner.
• Accurately and efficiently processes unidentified payments and unapplied activity accounts in a timely manner.
• Understands technical primary and secondary billing requirements for assigned third party payers and contracts.
• Consistently and accurately documents accounts with activities as needed in a timely manner.
• Identifies and notifies management of customer service issues and potential process/system problems that cause billing and payment errors and assists in improvement implementation as requested.
• Reads and comprehends correspondence from government and third-party payers to keep abreast of new regulations, policies and billing and payment requirements.
• Assists with the revision or development of the department's internal documents, procedural manuals and forms, as requested.
• Answers questions from other staff or clinic offices by phone or e-mail in a timely manner.

Required for All Jobs

• Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health
• Performs other duties as assigned

Patient Facing Options

• Position is Not Patient Facing

Remote Work Guidelines

• Workspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards.
• Stable access to electricity and a minimum of 25mb upload and internet speed.
• Dedicate full attention to the job duties and communication with others during working hours.
• Adhere to break and attendance schedules agreed upon with supervisor.
• Abide by Stormont Vail’s Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually.

Remote Work Capability

• Hybrid

Scope

• No Supervisory Responsibility
• 
  
• No Budget Responsibility No Budget Responsibility

Physical Demands

• Balancing: Rarely less than 1 hour
• Carrying: Rarely less than 1 hour
• Climbing (Stairs): Rarely less than 1 hour
• Driving (Automatic): Rarely less than 1 hour
• Eye/Hand/Foot Coordination: Frequently 3-5 Hours
• Feeling: Rarely less than 1 hour
• Grasping (Fine Motor): Occasionally 1-3 Hours
• Grasping (Gross Hand): Rarely less than 1 hour
• Handling: Rarely less than 1 hour
• Hearing: Frequently 3-5 Hours
• Kneeling: Rarely less than 1 hour
• Lifting: Occasionally 1-3 Hours up to 10 lbs
• Pulling: Occasionally 1-3 Hours up to 10 lbs
• Pushing: Occasionally 1-3 Hours up to 10 lbs
• Reaching (Forward): Rarely less than 1 hour up to 10 lbs
• Reaching (Overhead): Rarely less than 1 hour up to 10 lbs
• Repetitive Motions: Occasionally 1-3 Hours
• Sitting: Frequently 3-5 Hours
• Standing: Occasionally 1-3 Hours
• Talking: Frequently 3-5 Hours
• Walking: Occasionally 1-3 Hours

Stormont Vail is an equal opportunity employer and adheres to the philosophy and practice of providing equal opportunities for all employees and prospective employees, without regard to the following classifications: race, color, ethnicity, sex, sexual orientation, gender identity and expression, religion, national origin, citizenship, age, marital status, uniformed service, disability or genetic information. This applies to all aspects of employment practices including hiring, firing, pay, benefits, promotions, lateral movements, job training, and any other terms or conditions of employment.

Retaliation is prohibited against any person who files a claim of discrimination, participates in a discrimination investigation, or otherwise opposes an unlawful employment act based upon the above classifications.