Patient Financial Specialist Lead -Traditional Medicare Collections (Hiring Incentive Available)
Location: Irving, Texas
Admin / Clerical
Internal Number: 10941402
The associate is responsible for the duties and services that are of a support nature to the Revenue Cycle division of CHRISTUS Health. The associate ensures that all processes are performed in a timely and efficient manner. The primary purpose of this position is to ensure account resolution and reconciliation of outstanding balances for CHRISTUS Health patient accounts. The position works in a cooperative team environment to provide value to internal and external customers. The associate must demonstrate a consistently high degree of proficiency in their primary position within Patient Financial Services Department of CHRISTUS Health. The associate is responsible for a variety of activities in the department while applying one's expertise and knowledge within the unit. The position provides opportunities to increase one's scope of responsibility within the PFS Department. Working in partnership with the management team, serves as a resource for innovation, staff support and process improvements.
The Patient Financial Specialist Lead carries out his/her duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of CHRISTUS Health and fully supports CHRISTUS Health's core values of Dignity, Integrity, Compassion, Excellence and Stewardship.
Functions as a subject matter expert in support of other PFS team members and other departments/facilities within the CHRISTUS Health network.
Provides on the job training as needed and provides source of knowledge for staff inquiries.
Demonstrates a strong understanding of payer benefits requirements, on-line claims status, submission, billing, cash application, and reconciliation procedures.
Approve or deny requested adjustments and refunds within role thresholds.
Adapt to process and procedure evaluations and improvements, support continuous change, and willingly manage special projects in addition to normal workload and other duties as assigned.
Remain flexible if duties are reassigned, which may involve transferring to a more appropriate unit in order to best serve PFS and CHRISTUS Health.
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution while maintaining account integrity and compliance with payer and/or government regulations.
Ensures quality and productivity standards are met or exceeded.
Appropriately documents patient accounting host system or other systems utilized by Patient Financial Services in accordance with policy and procedures.
Provides continuous updates and information to PFS Leadership Team regarding errors, issues, and trends related to activities affecting productivity, reimbursement, payment delays, and/or patient experience.
Functions effectively within a team and participates and contributes constructively to produce results in a cooperative effort.
Continually seeks to understand and act upon customer needs, concerns, and priorities. Meets customer expectations and requirements, and gains customer trust and respect.
Demonstrates expertise in role requirements as outlined in job description for specific area of responsibility.
Review and work claim edits.
Works payor rejected claims for resubmission.
Works reports and billing requests.
Demonstrates strong knowledge of standard bill forms and filing requirements.
Exhibits and understanding of electronic claims editing and submission capabilities.
Correct claims in RTP status in designated claim system per Medicare guidelines.
Maintains an active knowledge of all governmental agency requirements and updates.
Three (3) years of experience and working knowledge of primary position within PFS preferred. Strong candidates, with supervisor/manager recommendation, may be fast tracked to a Team Lead position prior to reaching the 3-year experience requirement based on consistent display of qualities listed above.
In-depth knowledge and ability to maneuver efficiently through Patient Accounting Systems, Document Imaging, Databases, etc. Strong understanding of systems from an end-user and processing perspective.
Good technical aptitude working with a variety of MS Office products (Word, Excel, PowerPoint, Outlook) and/or ability to learn and develop more advance skills with the various applications.
Professional and effective written and verbal communication required.
Good understanding of the various areas of government, non-government programs, billing, customer service and cash applications.
Demonstrated success working in a team environment focused on meeting organization goals and objectives required.
Experience in role requirements as outlined in job description for specific area of responsibility preferred.
College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
Understanding of alternative Business Office financial resources and the ability to provide information and/or recommendations related to these sources of recovery are preferred.
Experience working within a multi-facility hospital business office environment preferred.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.