Experienced Patient Financial Services Claims Representative - Home Care - Remote

Apply for this position Please mention DailyRemote when applying
Posted 10 days ago United States Salary undisclosed
Before you apply - make sure the job is legit.

Attempting to apply for jobs might take you off this site to a different website not owned by us. Any consequence as a result for attempting to apply for jobs is strictly at your own risk and we assume no liability.

Job Description

Primary City/State:

Gilbert, Arizona

Department Name:

Work Shift:

Day

Job Category:

Revenue Cycle

Primary Location Salary Range:

$16.56/hr - $24.84/hr, based on education & experience

In accordance with Colorado's EPEWA Equal Pay Transparency Rules.

A rewarding career that fits your life. Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, apply today.

Patient Financial Services HME Operations collect for Home Care services including medical equipment needs within a patients home. As PFS Rep for Banner Home Care, you will be working an aging report to resolve accounts accurately and in a timely manner. We are a small close knit team that enjoys working with each other and understands the importance of where one is weak another is strong.

Patient Financial Services (PFS) Representatives are responsible for accurate billing of services rendered, timely and accurate collection of expected reimbursement. These functions are accomplished by review of initial claims to ensure clean claim submissions. Review and follow up on billed claims to investigate reason for payment delays or denials by contacting the payer or researching the payer website. Calling payers to verify receipt of claims, what is needed to resolve unpaid accounts, short paid claims and/or other complex denials. Take incoming calls from patients to assist with resolving their Commercial Insurance questions as well as self-pay balances. Once the payer has satisfied the expected reimbursement any patient responsibility balance is billed to the patient. Clear documentation of all work activity in the Ms4 account to ensure continuity throughout the entire revenue cycle.

This can be a remote position if you live in the following states only: AR, AZ, CA, CO, FL, IA, ID, MO, ND, NE, NV, TX, UT, WA, WI, WY

POSITION SUMMARY
This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner.

CORE FUNCTIONS
1. May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing.

2. As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company's collection/self-pay policies to ensure maximum reimbursement.

3. May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary.

4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients.

5. Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.

6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.

7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.

8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.

MINIMUM QUALIFICATIONS
High school diploma/GED or equivalent working knowledge.

Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences.

Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.

PREFERRED QUALIFICATIONS
Work experience with the Company's systems and processes is preferred. Previous cash collections experience is preferred.

Additional related education and/or experience preferred.