Patient Financial Specialist

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, with the primary purpose being account resolution and reconciliation of outstanding balances for CHRISTUS Health patient accounts. This role works in a cooperative team environment to provide value to internal and external customers, adhering to ethical standards and supporting CHRISTUS Health's Mission and core values.

Responsibilities:

General 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 regarding claims submission.
• Responds to all types of account inquiries through written, verbal, or electronic correspondence.
• Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations.
• Responsible for professional and effective communication with both internal and external customers.
• Meets or exceeds customer expectations and requirements.
• Compliant with all regulations.
• Exhibits a strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
• Documents in the patient accounting host system according to policy and procedures.
• Provides updates to the PFS Leadership Team regarding productivity, reimbursement, payment delays, or patient experience issues.

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 an understanding of electronic claims editing and submission capabilities.
• Correct claims in RTP status in the designated claim system as per Medicare guidelines.

Collections

• Collect balances due from payors ensuring proper reimbursement for services.
• Identifies and forwards proper account denial information for resolution.
• Maintains knowledge of governmental agency requirements and updates.
• Works collector queue daily using appropriate collection systems and reports.
• Identifies and resolves underpayments and credit balances within payor guidelines.

Vendor Coordinator

• Acts as liaison between external vendors and Revenue Cycle departments.
• Manages account transfers and coordinates reviews with external parties.
• Maintains department reports measuring vendor performance.
• Audits vendor remittances to ensure compliance with contracts.

Job Requirements:

Education/Skills

• HS Diploma or equivalent experience required.
• Post HS education preferred.

Experience

• 1-3 years of experience preferred.
• Experience in a multi-facility hospital business office environment preferred.

Licenses, Registrations, or Certifications

• None required.

Work Schedule:

TBD

Work Type:

Full Time

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