Patient Financial Specialist - Billing (Hiring Incentive Available)

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.

• Collects and provides patient and payor information to facilitate account resolution.
• Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding for account resolution.
• Compliant with all CHRISTUS Health, payer and government regulations.
• Meets or exceeds customer expectations and requirements, and gains customer trust and respect.
• Ensures PFS departmental quality and productivity standards are met.
• Appropriately documents patient accounting host system or other systems utilized by PFS in accordance with policy and procedures.
• Responds to all types of account inquires through written, verbal or electronic correspondence.
• 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.
• Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health key performance metrics.
• 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.
• Exhibits a strong working knowledge of CPT, HCPCS and ICD-10 coding regulations and guidelines.
• 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

Billing

• Correct claims in RTP status in designated claim system per Medicare guidelines.
• Demonstrates strong knowledge of standard bill forms and filing requirements.
• Maintains an active knowledge of all governmental agency requirements and updates.
• Works reports and billing requests.
• Works payor rejected claims for resubmission.
• Review and work claim edits.
• Exhibits and understanding of electronic claims editing and submission capabilities.

Collections

• Identify and communicate trends impacting account resolution.
• Identify and resolve underpayments with the appropriate follow up activities within payor timely guidelines.
• Maintain an active knowledge of all governmental agency requirements and updates.
• Identify and resolve credit balances with the appropriate follow up activities within payor timely guidelines.
• Working knowledge of the CMS 838 credit balance report.
• Corrects claims in RTP status in designated claim system per Medicare guidelines.
• Works collector queue daily utilizing appropriate collection system and reports.
• Initiates Medicare Redetermination, Reopening and/or Reconsideration as needed.
• Collect balances due from payors ensuring proper reimbursement for all services.
• Demonstrates knowledge of standard bill forms and filing requirements.
• Identifies and forwards proper account denial information to the designated departmental liaison. Dedicates efforts to ensure a proper denial resolution and timely turnaround.

Requirements:

• Experience working within a multi-facility hospital business office environment preferred.
• Understanding of Medicare language.
• 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.
• College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
• 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.
• Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Work Type:

Full Time

117222

Patient Financial Specialist - Billing (Hiring Incentive Available)

CHRISTUS System Office

Revenue Cycle

CHRISTUS Corp Irving Offices 919 and 909 Buildings

FULL TIME