Senior Patient Financial Services Representative - Fairview Health Services
St Paul, MN 55104
About the Job
Fairview Health Services has an opportunity for a Senior Patient Financial Services Representative to be working on site at our Midway Campus in St Paul, MN! This position supports management in the billing and collection of accounts receivable for inpatient and outpatient accounts and/or resolving customer service issues. We seek individuals who understand the revenue cycle and the importance of evaluating and securing all appropriate financial resources for patients to improve reimbursement to the health system. This includes all revenue cycle processes: insurance verification, acquiring prior authorizations, billing, claim follow up, and denial management.
This position is apoproved for 80 hours every two weeks. Are you interested in benefits? We offer medical, dental, and vision coverage along with PTO and 403B!
Join M Health Fairview, where we're driven to heal, discover, and educate for longer, healthier lives.
Responsibilities/Job Description:This position is responsible for billing and collection of accounts receivable for inpatient and outpatient accounts, ensures expected payment is collected and accounts are fully resolved, and resolves complex customer service issues. This position understands the importance of evaluating and securing all appropriate financial resources for patients to ensure proper adjudication.
- Intentionally prevents untimely revenue shortfalls by taking action to resolve financial transactions appropriately and effectively to ensure collection of expected payment; escalates issues when appropriate.
- Accelerates business outcomes by identifying ways to fully resolve accounts through single-touch resolution when possible.
- Understands revenue cycle and the importance of evaluating and securing all appropriate reimbursements from insurance or patients.
- Contacts payers via portal or provider service center to facilitate timely and accurate resolution of accounts.
- Responsible for verification of insurance and/or patient demographics
- Makes appropriate contacts with payers and other necessary parties to obtain and/or provide data or information needed to facilitate timely and accurate account resolution to expedite outcomes.
Verifier:
Patient registration and insurance knowledge. Billing practices and research of patient demographics from inside and outside company sources
Timely processing and follow-up of patient requests for demographics and insurance
Coding/Charging:
The Coding Representative will code the run from the patient care report (PCR) and add appropriate charges accordingly. The Representative will manage MHealth Fairview EMS balances in the ImageTrend/Billing Bridge system and understand in depth the ambulance and MedKab billing process and functions that are necessary to resolve accounts.
Timely processing and follow-up of patient requests for coding and charging review
Work independently in problem solving with patients regarding their account.
Follow up/Denials/Credits:
Demonstrate a high degree of proficiency in billing and/or collection of multiple payers (both government and non-government) billing and collection practices.
Responsible for the analysis and processing of correspondence including rejections, PCS forms, and all paperwork pertaining to ambulance billing requirements.
Identify problem accounts and work towards timely resolution.
Communicate effectively via the telephone or written communication with patients or departments to obtain and provide all information for payers to process and pay claims quickly and accurately.
Resolve credit balances and submit for refunds from the system.
Liaison with Medicare and other payers for audits
Customer Service Representative:
Maintains the best practice routine per department guidelines.
Timely processing and follow-up of patient requests for payment research, checking charges, insurance processing concerns.
Notifies patient and/or guarantor of co-pays/deductible/coinsurance.
Work independently in problem solving with patients regarding their account.
Uninsured accounts reviewed and managed to include validation that uninsured discounts have been appropriately applied, and all payment sources available to the patient have been explored.
Demonstrate a high degree of proficiency in billing and/or collection of multiple payers (both government and non-government) billing and collection practices.
Responsible for the analysis and processing of correspondence including rejections, requests for medical records, itemized bills, clarification of detail on bill, etc. Analyze paid claims for accuracy of payments and or rejections and properly account for payment and adjustments by both payers and patients.
Reviews explanation of benefits for accuracy in posting and assisting patient’s in understanding their patient liability.
Identify problem accounts and work towards timely resolution.
Communicate effectively via the telephone or written communication with patients or departments to obtain and provide all information for payers to process and pay claims quickly and accurately.
Bad debt management of accounts and interactions with vendors.
Counsel patients throughout the collection process on solutions available to them for account resolution.
Problem solve with vendors and patient on reasonable resolutions.
Identify patients with financial need.
Work directly with Collection agency and the Department of Revenue, Revenue Recapture Program maintaining all documents and following required guidelines set by the state of MN.
Required
2 years in a medical billing office setting or relevant experience
- Certified Ambulance Coder (CAC); must obtain within 9 months of hire date
Preferred
2 years of medical billing office setting experience
MS Office experience
Insurance / follow up experience
Coordination of benefits experience
Epic, Brightree, Billing Bridge, or comparable software account experience
Experience working with medical terminology
Experience working with CPT-4 and ICD-10
Extensive knowledge of FV account review experience
Extensive knowledge of FV system applications
Extensive knowledge of FV RCM workflows
Billing certification
Substantial system super user experience
- Ambulance billing, follow up, verification or coding
- Knowledge of Image Trend Billing Bridge software