Operating a hospital is more than IV bags and trauma rooms. One might be surprised by the number of people – and the hats they wear – who work behind the scenes to make sure a hospital runs smoothly and safely for our patients, visitors and staff. Each one plays a critical role and is part of a team to ensure the best care for our patients.
Banner Health currently has openings for direct hire Patient Financial Services Representatives positions.
The PFS Rep department includes:
Commercial Insurance/Contracts Division
AHCCCS, Blue Cross, Tricare, VA, Work Comp and Audits Division
Medicare/Medicare Advantage Division
The PFS Department is responsible for the timely and accurate billing and collections of revenue based on CMS guidelines, payer contracts and federal regulations. We strive to create an environment that engages employees to produce at the highest level and recognition for their accomplishments. All individual and team work assignments are designed to collectively meet Banner’s goals emphasizing excellent customer service and making a difference in our customer’s lives.
PFS Rep Day to Day Responsibilities:
PFS Representatives are responsible for accurate billing of services rendered, timely and accurate collection of expected reimbursement. Once the payer has satisfied the expected reimbursement any patient responsibility balance is billed to the patient. These functions are accomplished by:
Review of Initial claims to ensure clean claim submission
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
Clear documentation of all work activity in the Ms4 account to ensure continuity throughout the entire revenue cycle
Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
Please note: This is a requisition for various Patient Financial Services Representative positions that are open at the Banner Corporate Center - Mesa. During the application process, you will have the opportunity to apply to multiple positions attached to this requisition. Applicants will be considered accordingly.
About Banner Health Corporate
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to change the way care is provided. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.
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.
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.
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 companys collection/self-pay policies to ensure maximum reimbursement.
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.
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.
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.
Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
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.
Work experience with the Companys systems and processes is preferred. Previous cash collections experience is preferred.
Additional related education and/or experience preferred.