Patient Financial Services
Company: CHRISTUS Health
Location: Irving
Posted on: August 5, 2022
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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.
Performs Revenue Cycle functions in a manner that meets or exceeds
CHRISTUS Health 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 Revenue
Cycle.
Responsible for professional and effective written and verbal
communication with both internal and external customers in order to
resolve outstanding 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.
Provides continuous updates and information to PFS Leadership Team
regarding errors, issues, and trends related to activities
affecting productivity, reimbursement and/or payment delays.
Role Specific Responsibilities
Collections
Collect balances due from payors ensuring proper reimbursement for
all services.
Identifies and forwards proper account denial information to the
designated departmental liaison. Dedicates 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 designated claim system per
Medicare guidelines.
Initiates Medicare Redetermination, Reopening and/or
Reconsideration as needed.
Working knowledge of the CMS 838 credit balance report.
Requirements:
Prefer minimum of 2 years' experience with insurance billing,
collections, payment and reimbursement verification and/or
refunds.
Professional and effective written and verbal communication
required.
Experience working within a multi-facility hospital business office
environment 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.
Experience working 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
Work Type:
Full Time
Keywords: CHRISTUS Health, Irving , Patient Financial Services, Accounting, Auditing , Irving, Texas
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