This position is responsible for providing Fairview Health Services patients an understanding of the billing and insurance processing of their healthcare services. The CSC Representative will counsel patients on financial solutions available to them either through direct payments, payment plans, or screening for qualification for assistance programs. The CSC Representative will manage MHealth Fairview EMS balances in the RescueNet system and understand in depth the ambulance and MedKab billing process and functions that are necessary to resolve accounts. They will also be well-versed in collection practices, understanding of the Attorney General Requirements, and able to liaison with bad debt vendors when needed. They will have detailed knowledge of the Functions within the Revenue Cycle and how they interact in the life of a patient account.
This job is onsite at our Midway Corporate Campus in St. Paul.
Maintains the best practice routine per department guidelines.
Handles fair share of calls presented to CSC through automated call distribution system. Able to work independently with patients in resolving questions and concerns.
Timely processing and follow-up of patient requests for payment research, checking charges, insurance processing concerns.
Notifies patient and/or guarantor of co-pays/deductible/coinsurance.
Work independently in problem solving with patients regarding their account.
Uninsured accounts reviewed and managed to include validation that uninsured discounts have been appropriately applied, and all payment sources available to the patient have been explored.
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.
Manage accuracy of accounts to insure appropriate billing and compliance with patient privacy and data integrity.
Gathers data, summarizes and prepares reports for management and completes special projects as assigned.
Work independently to manage special projects as assigned.
Assists customers regarding billing questions and ensures appropriate resolution of problems. Explain and interpret eligibility rules and regulations or identify other resources available for financial assistance. Identify patients who may be eligible for financial exceptions. Keep updated on changes with regulatory issues.
Validate patient data is accurate and authorization is in place to provide information.
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.
Identify patients with financial need.
Attends periodic meetings with payer representatives to discuss discrepancies and assist in developing action plan for correction.
Minimum Qualifications to Fulfill Job Responsibilities:
2-4 years customer service experience and/or experience within a Health Care setting, preferably with ambulance PFS experience
2+ years in healthcare customer service and/or 3 years experience in a hospital, clinic or Transportation business office
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership ...with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.