Claims Follow Up PFS Representative CBO

Posted:
10/15/2024, 3:46:31 PM

Location(s):
Arizona, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Customer Success & Support

Workplace Type:
Remote

Primary City/State:

Arizona, Arizona

Department Name:

Acute Billing & Follow Up-Corp

Work Shift:

Day

Job Category:

Revenue Cycle

Great careers are built at Banner Health. We understand that talented professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices including remote work options. Apply today, this could be the perfect opportunity for you.

You will work in a Patient Financial Services (PFS) Department responsible for the timely and accurate billing and collections of revenue based on CMS guidelines, payer contracts and federal regulations. Our team provides a supportive environment, and you will have many opportunities to grow and advance in your career path. We strive to create an environment that engages employees to produce at the highest level and recognition for their accomplishments. Your individual and teamwork assignments are designed to collectively meet Banner’s goals emphasizing excellent customer service and making a difference in our customer’s lives.

As a Patient Financial Services Representative, you will work to reduce accounts receivable balances for Arizona Complete and Care1st payors ensuring reimbursement of services. Will be working with provider reps and payers to resolve any issues, phone calls, emails, portals to follow up on claims.

Systems frequently used: MS4 FinThrive, FinThrive Collections, Cerner, OnBase

Desired Experience: Claims Follow Up

Monday - Friday 8am - 4:30pm AZ Time (some flexibility after training between 6am to 6pm, 8 hours per day )

This can be a remote position if you live in the following states only: AK, AZ, AR, CA, CO, GA, FL, IA, ID, IN, KS, KY, LA, MD, MI, MO, MN, MS, NH, NM, NY, NC, ND, NE, NV, OH, OK, OR, PA, SC, TN, TX, UT, VA, WI, WV, WA, & WY 

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 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.

CORE FUNCTIONS
1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

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

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

8. 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 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.

PREFERRED QUALIFICATIONS
Work experience with the Company’s systems and processes is preferred. Previous cash collections experience is preferred.

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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