Blending
Care
and Expertise
Patient Financial Representative
Location: Irving, Texas
Date Posted: 13 Nov, 2024
Job Summary:
The Patient Financial Representative ensures the efficient resolution and reconciliation of outstanding balances for facility patient accounts.
This role is responsible for performing key Revenue Cycle functions to meet facility performance metrics and departmental quality standards.
The representative will handle patient and payer account inquiries, follow up on insurance and self-pay accounts, and ensure compliance with billing and coding regulations.
Additionally, this role involves identifying payment discrepancies and communicating issues to enhance productivity, reimbursement, and the patient experience.
Key Responsibilities:
- Resolve outstanding account balances and reconcile facility patient accounts efficiently.
- Collect and document patient and payer information to facilitate account resolution.
- Respond to inquiries regarding accounts via written, verbal, or electronic communication.
- Maintain updated knowledge of insurance, self-pay billing guidelines, and third-party payer regulations.
- Apply working knowledge of CPT, HCPCS, and ICD-10 coding for accurate account handling.
- Provide regular updates to PFS Leadership on productivity and reimbursement issues or trends.
- Manage patient accounts, ensuring proper documentation in patient accounting systems.
- Address account denials and underpayments, following up within payer guidelines.
- Identify and resolve credit balances and communicate trends impacting account resolution.
Required Qualifications:
- Minimum of two years of experience in insurance billing, collections, payment verification, and reimbursement processes.
- Familiarity with inpatient and outpatient billing forms, such as UB-04 and HCFA 1500.
Preferred Qualifications:
- College education or healthcare billing trade school certification may substitute for formal hospital experience.
- Prior experience in a multi-facility hospital business office setting.
- Previous claims experience within an insurance company or healthcare setting.
- Strong understanding of healthcare billing and coding practices, with experience in UB-04 and HCFA 1500 billing requirements.
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