• Senior Patient Financial Services Representative

    Fairview Health Services (St. Paul, MN)


    Job Overview

    M Health Fairview's Revenue Cycle Department has a new work from home opportunity. We have an opportunity for a Senior Patient Financial Services (PFS) Representative to join our DME Billing Team! This position is responsible for billing and collection of accounts receivable for inpatient and outpatient accounts, ensures expected payment is collected and accounts are fully resolved, and resolves complex customer service issues. This position understands the importance of evaluating and securing all appropriate financial resources for patients to ensure proper adjudication.

     

    This opportunity is fully benefit eligible. Our benefits package includes medical, dental, and vision coverage. We encourage staff development and support continuing education. This is a work from home position, day shift, weekdays. It is a 1.0 FTE (80 hours per 2 weeks).

     

    + Follow-up/Billing

    + Dependent on knowing denial/rejection codes, insurance guidelines and compliance.

    + Customer service (mini call center)

    + Maintains the best practice routine per department guidelines.Dependent on knowledge of phones, insurance guidelines, collection processes, personal skills for dealing with customer, Self-pay/Collections de-escalations tactics, payment research

    + Timely processing and follow-up of patient requests for payment research, checking charges, insurance processing concerns.

    + Work independently in problem solving with patients regarding their account.

    + Demonstrate a high degree of proficiency in billing and/or collection of multiple payers (both government and non-government) billing and collection practices.

    + Responsible for the analysis and processing of correspondence including rejections, requests for medical records, itemized bills, clarification of detail on bill, etc. Analyze paid claims for accuracy of payments and or rejections and properly account for payment and adjustments by both payers and patients.

    + Reviews explanation of benefits for accuracy in posting and assisting patients in understanding their patient liability.

    + Identify problem accounts and work towards timely resolution.

    + Communicate effectively via the telephone or written communication with patients or departments to obtain and provide all information for payers to process and pay claims quickly and accurately.

    + Bad debt management of accounts and interactions with vendors.

    + Counsel patients throughout the collection process on solutions available to them for account resolution.

    + Problem solve with vendors and patient on reasonable resolutions.

    + Refunds - dependent on use of Onbase

    + Patient Insurance

    + Confirming of sales orders (100% quality review) - Dependent on payor guidelines, compliance, and knowledge of equipment

    + Authorizations - Dependent on payor guidelines

    + Verifications – Dependent on Onesource (Experian), payor portal

    Required

    2 years in a medical billing office setting or relevant experience

     

    Detail oriented

     

    Ability to problem solve and able to utilize resources independently

     

    Preferred

     

    Durable Medical Equipment billing and follow up experience

     

    Medical terminology

     

    Knowledge of insurance processing and/or understanding of explanation of benefits

     

    Coordination of benefits process

     

    Knowledge of various systems (Brightree, EPIC, OnBase, etc.)

     

    Knowledge of ICD-10 coding.

     

    Ability to work independently.

     

    Ability to adapt with rapid changes.

     

    A quick learner who can retain various payor billing criteria consistently.

     

    Microsoft Office 365

     

    Benefit Overview

     

    Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

     

    Compensation Disclaimer

     

    An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical.

     

    EEO Statement

     

    EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status