Senior Patient Financial Services Representative - Medicare and Medicare Advantage

Company: Banner Health
Location: Mesa
Posted on: May 17, 2022

Job Description:

Primary City/State:Mesa, ArizonaDepartment Name: Acute Billing & Follow Up-CorpWork Shift: DayJob Category:Revenue CycleA rewarding career that fits your life. Those who have joined the Banner mission come from all walks of life, united by the common goal: Make health care easier, so life can be better. If changing health care for the better sounds like something you want to be part of, apply today.You will work on 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. You will be assigned to a specific team of 10-15 Patient Financial Services Representatives dedicated to work with specific payor group(s). 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 team work assignments are designed to collectively meet Banner's goals emphasizing excellent customer service and making a difference in our customer's lives. - -As a Central Business Office Patient Financial Services Senior Representative, you will not only work as an individual contributor to reduce accounts receivable balances ensuring reimbursement of services; You will also serve as additional support providing employee support, mentoring, responding to escalated calls with Patient Financial Services Representatives and providing additional reporting requests as needed.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 SUMMARYThis 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 FUNCTIONS1. 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.Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.MINIMUM QUALIFICATIONSHigh 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 QUALIFICATIONSWork 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.DATE APPROVED 03/13/2016

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