Description
Summary :
The associate is responsible for the duties and servicesthat are of a support nature to the Revenue Cycle division ofCHRISTUS Health.
The associate ensures that all processes areperformed in a timely and efficient manner. The primary purpose ofthis position is to ensure account resolution and reconciliation ofoutstanding balances for CHRISTUS Health patient accounts.
Theposition works in a cooperative team environment to provide valueto internal and external customers.
The associate carries out his / her duties by adhering tothe highest standards of ethical and moral conduct, acts in thebest interest of CHRISTUS Health, and fully supports CHRISTUSHealth's Mission, Philosophy, and core values of Dignity,Integrity, Compassion, Excellence, and Stewardship.
Responsibilities :
- Meets expectations of the applicableOneCHRISTUS Competencies : Leader of Self, Leader of Others, orLeader of Leaders.
- Performs Revenue Cyclefunctions in a manner that meets or exceeds CHRISTUS Health's keyperformance metrics.
- Ensures PFS departmentalquality and productivity standards are met.
- Collects and provides patient and payorinformation to facilitate account resolution.
- Responds to all types of account inquiriesthrough written, verbal, or electroniccorrespondence.
- Maintains payor-specificknowledge of insurance and self-pay billing and follow-upguidelines and regulations for third-party payers.
Maintainsworking knowledge of all functions within the Revenue Cycle.
- Responsible for professional and effectivewritten and verbal communication with both internal and externalcustomers in order to resolve outstanding questions for accountresolution.
- Meets or exceeds customerexpectations and requirements, and gains customer trust andrespect.
- Compliant with all CHRISTUS Health,payer, and government regulations.
- Exhibits astrong working knowledge of CPT, HCPCS, and ICD-10 codingregulations and guidelines.
- Appropriatelydocuments patient accounting host system or other systems utilizedby PFS in accordance with policy andprocedures.
- Provide continuous updates andinformation to the PFS Leadership Team regarding errors, issues,and trends related to activities affecting productivity,reimbursement, payment delays, and / or patientexperience.
- Must have professional andeffective written and verbal communication.
Billing
- Review and work on claim edits.
- Works payor rejected claims for resubmission.
- Works reports and billing requests.
- Demonstrates strong knowledge of standard billforms and filing requirements.
- Exhibits andunderstanding of electronic claims editing and submissioncapabilities.
Collections
- Collect balances due frompayors ensuring proper reimbursement for allservices.
- Identifies and forwards properaccount denial information to the designated departmental liaison.Dedicated efforts to ensure a proper denial resolution and timelyturnaround.
- Maintain an active knowledge ofall collection requirements by payors.
- Workscollector queue daily utilizing appropriate collection system andreports.
- Demonstrates knowledge of standardbill forms and filing requirements.
- Identifyand resolve underpayments with the appropriate follow-up activitieswithin payor timely guidelines.
- Identify andresolve credit balances with the appropriate follow-up activitieswithin payor timely guidelines.
- Identify andcommunicate trends impacting account resolution.
Cash Reconciliation
- Ensures all payments areretrieved and posted accurately and timely through reconciliationof patient accounting system and bankstatement.
- Researches submitted cash paymentsby verifying patient account numbers and appropriatefacilities.
- Monitor and performs cashreconciliation to identify cash posting errors and ensures allreceipts are applied and reconciles to daily bank deposit andmonthly bank statements.
- Review and post cashcorrections, including resolving patient complaints and inquiriesfrom PFS, Finance, Facilities, and VendorPartners.
- Resolve and Research unapplied cash,including continuous follow-up until payment identification is madefor application of payment or refund.
Requirements :
- HS Diploma or equivalent years of experiencerequired.
- Post HS educationpreferred.
- 3-5 years of experiencepreferred.
- Experience working within amulti-facility hospital business office environment preferred.
- College education, previous Insurance Companyclaims experience and / or health care billing trade school educationmay be considered in lieu of formal hospitalexperience.
- Experience working withinpatient and outpatient billing requirements of UB-04 and HCFA1500 billing forms preferred.
Work Type : Full Time
Full Time
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