Patient Financial Specialist - Financial Services
Company: Christus Health
Location: Irving
Posted on: September 27, 2024
|
|
Job Description:
Description
Summary: 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
position 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. Responsible to perform the
necessary research in order to determine proper governmental
requirements prior to claims submission. --- Responds to all types
of account inquires 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. Maintains working knowledge of all functions
within the Revenue Cycle. --- Responsible for professional and
effective written and verbal communication with both internal and
external customers in order to resolve outstanding questions for
account resolution. --- 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. --- Professional and effective written and verbal
communication required. Billing--- Review and work on claim edits.
--- Works payor rejected claims for resubmission. --- Works reports
and billing requests. --- Demonstrates strong knowledge of standard
bill forms and filing requirements. --- Exhibits and understanding
of electronic claims editing and submission capabilities. ---
Correct claims in RTP status in the designated claim system per
Medicare guidelines. --- Maintains an active knowledge of all
governmental agency requirements and updates. Collections---
Collect balances due from payors ensuring proper reimbursement for
all services. --- Identifies and forwards proper account denial
information to the designated departmental liaison. Dedicated
efforts to ensure a proper denial resolution and timely turnaround.
--- Maintain an active knowledge of all governmental agency
requirements and updates. --- Works collector queue daily utilizing
appropriate collection system and reports. --- Demonstrates
knowledge of standard bill forms and filing requirements. ---
Identify and resolve underpayments with the appropriate follow-up
activities within payor timely guidelines. --- Identify and resolve
credit balances with the appropriate follow-up activities within
payor timely guidelines. --- Identify and communicate trends
impacting account resolution. --- Corrects claims in RTP status in
the designated claim system per Medicare guidelines. --- Initiates
Medicare Redetermination, Reopening and/or Reconsideration as
needed. --- Working knowledge of the CMS 838 credit balance report.
Vendor Coordinator--- Acts as liaison between external vendors and
Revenue Cycle departments to monitor external vendor activities and
ensures accounts placed for collection are received timely and
acknowledged as received by the vendor. --- Manages account
transfers between CHRISTUS Health and the various contracted
vendors. --- Coordinates with Revenue Cycle Managers (Collections,
Billing, Cash Applications, etc.) to review of selected accounts
prior to transfer and placement with an external third party. ---
Ensures accounts deemed as closed or uncollectible by the vendors
are properly reflected in applicable AR systems. --- Maintains
department reports measuring agency performance, which includes
account placements, collections, returns, and performance metrics.
--- Advises vendors of CHRISTUS Health billing and collection
procedures and ensures accounts identified with third-party
coverage are properly billed by the entities as requested by the
vendor. --- Audits all vendor remittances and ensures all fees
billed to CHRISTUS Health are in accordance with the contract and
include supporting documentation of payments posted to the account
on the patient accounting systems. --- Recalls accounts incorrectly
placed and/or as requested by Revenue Cycle Managers with the
external vendor and returns accounts to open receivables as
appropriate. --- Creates tools, reports, or documentation that
enables Revenue Cycle Leadership to understand, manage, and measure
their vendor's performance and to prioritize important
relationships. --- Performs account reconciliation between CHRISTUS
Health system and vendor system. Job Requirements:
Keywords: Christus Health, Lewisville , Patient Financial Specialist - Financial Services, Accounting, Auditing , Irving, Texas
Click
here to apply!
|