Patient Financial Representative Senior - Patient Financial Services

Support CHRISTUS Health’s Revenue Cycle as a senior patient financial professional, managing account resolution workflows, claims activity, collections, and cash reconciliation.

Responsibilities

• Meet expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Perform Revenue Cycle functions to meet or exceed CHRISTUS Health key performance metrics.
• Ensure Patient Financial Services (PFS) departmental quality and productivity standards are met.
• Collect and provide patient and payor information to facilitate account resolution.
• Respond to account inquiries via written, verbal, or electronic correspondence.
• Maintain payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers.
• Maintain working knowledge of all functions within the Revenue Cycle.
• Provide professional, effective communication with internal and external customers to resolve outstanding account questions.
• Comply with all CHRISTUS Health, payer, and government regulations.
• Apply strong knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
• Document patient accounting host system and other PFS systems in accordance with policy and procedures.
• Provide continuous updates to the PFS Leadership Team regarding errors, issues, and trends affecting productivity, reimbursement, payment delays, and/or patient experience.
• Work claim edits and support electronic claims editing and submission capabilities.
• Work payor rejected claims for resubmission.
• Work reports and billing requests.
• Demonstrate knowledge of standard bill forms and filing requirements.
• Collect balances due from payors to ensure proper reimbursement for services.
• Identify and forward proper account denial information to the designated departmental liaison.
• Contribute to denial resolution and timely turnaround.
• Maintain active knowledge of payor collection requirements.
• Use the collector queue daily with appropriate collection system and reports.
• Identify and resolve underpayments within payor timely guidelines using appropriate follow-up.
• Identify and resolve credit balances within payor timely guidelines using appropriate follow-up.
• Identify, research, and communicate trends impacting account resolution.
• Retrieve and post payments accurately and timely through reconciliation of the patient accounting system and bank statement.
• Research submitted cash payments by verifying patient account numbers and appropriate facilities.
• Monitor and perform cash reconciliation to identify cash posting errors; ensure receipts are applied and reconcile to daily bank deposits and monthly bank statements.
• Review and post cash corrections, including resolving patient complaints and inquiries from PFS, Finance, Facilities, and vendor partners.
• Resolve and research unapplied cash, with continuous follow-up until payment is identified for application or refund.

Requirements

• HS Diploma or equivalent (years of experience required).
• Post-HS education preferred.
• 3-5 years of experience preferred.
• Multi-facility hospital business office experience 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 with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 preferred.
• None required.

Schedule

• 8AM - 5PM, Monday-Friday

Work Type

• Full Time

Location

• San Antonio, TX (onsite)