Primary City/State:

Mesa, Arizona

Department Name:

Acute Billing & Follow Up-Corp

Work Shift:

Day

Job Category:

Revenue Cycle

8-10 WEEKS IN-OFFICE TRAINING 8:00AM - 4:30PM - AFTER TRAINING FLEXIBLE START TIMES

Explore and excel. At Banner, health care is a team effort.  One might be surprised by the number of people who work behind the scenes and play a critical role in ensuring the best care for our patients.  Apply today. 

The Claims Follow Up Patient Financial Services Representative 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   

Additionally, the Senior Patient Financial Services Representative may serve as a resource to their peers, assist with training new team members and will be working closely with other areas with in Banner and with payer reps.

Previous experience with billing/following up on claims needed

Systems frequently used: MS4, nThrive Collections, nThrive Claims, OneSource, Cerner, Payer Portals, Google

Monday - Friday between the hours of 7am - 5pm AZ Time

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.

POSITION SUMMARY
This position coordinates and facilitates patient billing and collection activities, following patient accounts through the billing process to the payor, working with the payor through claims processing, ensuring reimbursement to the facility. Provides leadership to the patient financial services team, participating in the selection and training of staff members. This position serves as a primary resource in complex and/or sensitive cases and may be assigned to work in any position in the department based on the departmental need.

CORE FUNCTIONS
1. Provides leadership and training to Patient Financial Services Representatives. Provides leadership for the team by successfully leading special projects, training staff, providing suggestions to improve processes and serving as a resource for complex and sensitive accounts.

2. As assigned, processes 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.

3. 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 company’s collection/self-pay policies to ensure maximum reimbursement.

4. As assigned, researches payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary.

5. 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.

6. Responds to incoming calls and makes outbound calls as required to resolve billing and payment issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.

7. Reduces Accounts Receivable balances. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts.

8. Uses systems to provide statistical data, prepare issues list(s) and to communicate with payors accurately.

9. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members.

MINIMUM QUALIFICATIONS
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 two or more years of work experience. Requires knowledge of medical terminology and a broad understanding of all common insurance and payor types and authorization requirements. 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.

PREFERRED QUALIFICATIONS
Work experience with the Company’s systems and processes is preferred. Previous cash collections experience is preferred. May have related experience with financial institution or background.

Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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