Patient Financial Services (PFS) Representative - Willcox
Northern Cochise Community Hospital Position Description
JOB TITLE: Patient Financial Services Representative
REPORTS TO: PFS Director
Performs a variety of clerical and accounting functions for patient billing, including verification of Remittance Advice information and maintenance of third party billing records. Performs follow-up on submitted claims in a timely manner, resubmitting and appealing claims as required. Resolves account discrepancies. Assists patients with billing questions and collects patient payments.
- Bills insurance carriers in accordance with billing requirements based on Financial Class assigned.
- Identify any trends requiring manual input into the Clearing House.
- Verify with payer any billing changes and advise PFS Director of changes needed in the Patient Accounting System or Clearing House.
Resolves aged accounts
- Follows up on submitted claims; monitors unpaid claims, and resubmits corrected claims as necessary based on financial class assignment.
- Files appeals and grievances as needed.
- Document Patient Accounting System with steps taken to ensure payment of claim is forthcoming in a timely manner.
- Assists patients with billing questions, discounts and financial assistance.
- Works with Insurance provider representatives to resolve payer edits, reject claims in a timely manner.
Researches and resolves account discrepancies
- Compares charges with documentation
- Issues requests for account adjustments, corrections, and refunds as required
- Other duties as assigned
- Basic registration processes
EDUCATION AND EXPERIENCE REQUIREMENTS
High School Diploma or equivalent required. One (1) - Two (2) years Accounts Receivable and or Registration experience in a hospital or physician office clerical setting preferred.
KNOWLEDGE/ SKILLS/ ABILITIES
- Knowledge of medical insurance claims procedures and documentation, and medical billing procedures.
- Strong written and verbal communication, problem solving, and organization skills.
- Ability to communicate effectively, both orally and in writing, verify data input and correct errors, gather data, compile information, and prepare reports.
- Ability to operate basic office machines such as fax, copier, and 10-key calculator.
- Familiarity with the basics of such computer programs as Microsoft Word, Excel and Outlook.