Description:
Location: Cherry County Hospital - Valentine, NE 69201
Compensation: Competitive wage based on experience
Position: Full-Time
Benefit Eligible: Yes
Position Summary
The Patient Financial Services Representative performs a variety of routine and non-routine clerical/patient accounting functions in accordance with standard procedures in one or more of the following areas: patient accounting, accounts receivable, or hospital revenue cycle for the Cherry County Hospital and Clinic.
Duties and Responsibilities:
Regular responsibilities include but are not limited to the following:
-
Works daily electronic billing file and submits insurance claims to third-party payers
-
This position is responsible for posting monies received from all payor types (including Medicare, Medicaid, Managed Care, HMO, PPO, and patient)
-
Accurate billing of patient accounts, ensuring timely claim submission and reimbursement from various third- party payers and patients, ensuring proper account documentation in the facility's billing system, and pursuing follow-up efforts on aged accounts
-
Reviews, evaluates, and forwards manual patient account statements to payers that do not accept electronic claims or that require special handling
-
Documents billing activity on the patient account; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to CFO
-
Reviews claims for accuracy and coordinates with ancillary departments as needed to provide information for audits and/or record reviews
-
Based on electronic payers' error reports, makes appropriate corrections to optimize the electronic claims submission process
-
Ensures payments and adjustments are accurately posted to patient accounts
-
Reviews claims for accuracy and coordinates with ancillary departments as needed to provide information for audits and/or record reviews
-
Based on electronic payers' error reports, makes appropriate corrections to optimize the electronic claims submission process
-
Ensures payments and adjustments are accurately posted to patient accounts
-
Ensures payments in correct computer log to assure accurate patient statements
-
Responds to written/oral requests for itemized bill from any customer including patient, insurance company, and attorney
-
Researches all patient and insurance refunds in accordance to best practice/benchmark for compliance
-
Calls patients to collect on outstanding balances, collecting insurance information, or providing payment options
-
Responds to patients inquiries regarding the status of insurance claims or balances due
-
Visits patients in the Emergency Department or the hospital to obtain information for billing or provider Medicaid application
-
Review outstanding patient balances prior to patients receiving elective services to secure appropriate payment arrangements and/or compliance with previously established payment arrangements
-
Ensures timely resolution of credits by accurate and timely refunds to the appropriate entity(s) and patient(s), prepares daily deposit and control sheets
-
Sorts the mail and is responsible for distribution to the appropriate area/person
-
Obtains pre-authorizations for services/procedures when required by the patient’s payor
-
Posts charges onto the patient account for supplies and services that were provided to the patient to ensure proper billing and reimbursement
-
Various other reporting and miscellaneous reports relating to Revenue Cycle functionality, Accounts Payable or Timekeeping could be required
-
Ensures the confidentiality of patients’ medical, personal, and financial records is maintained
-
Knowledgeable of and committed to practicing Corporate Compliance policies and procedures
-
Complies with Cherry County Hospital personnel policies
-
Performs other duties as assigned by the supervisor
Lead, duties and responsibilities:
-
Oversee day-to-day operations of department
-
Delegate tasks and set deadlines
-
Set clear team goals
-
Participate in recruitment and selection of team members
-
Train new team members and monitor their accuracy and productivity
-
Motivate and coach team members
-
Identify training needs and provide coaching
-
Resolve conflict; escalating as appropriate
-
Provides feedback regarding job performance for team performance evaluations
-
Serve as an effective role model, supporting department and organization changes
-
Foster an open communication culture and inspiring team environment
Why join Cherry County Hospital?
-
Supportive team environment
-
Meaningful work that helps keep patient care running smoothly
-
Opportunities for learning and professional growth
-
Competitive pay and benefits
If you are organized, detail-oriented, and enjoy working with people in a fast-paced healthcare environment, we would love to hear from you!
For more information about this opportunity, please reach out to our Human Resources Department.
Requirements:
Minimum Job Requirements
-
High School diploma required
-
1 to 3 years of customer service and/or business office experience, ideally in a medical setting preferred
-
Prior experience and knowledge in the use of software packages such as Microsoft Excel, Word, and Windows
-
Knowledge of collection laws, 3rd party reimbursement, and basic hospital accounting
