Patient Financial Specialist - Patient Financial Services

Join to apply for the Patient Financial Specialist - Patient Financial Services role at CHRISTUS Health

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 these positions is to ensure account resolution and reconciliation of outstanding balances for CHRISTUS Health patient accounts. The Job works in a cooperative team environment to provide value to internal and external customers.

The associate carries out his/her duties by adhering to the highest standards of ethical and moral conduct and fully supports CHRISTUS Health's Mission, Philosophy, and core values of Dignity, Integrity, Compassion, Excellence and Stewardship.

• Meets expectations of the applicable OneCHRISTUS
  
  Competencies:
  
  Leader of Self, Leader of Others, or Leader of Leaders.
• Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics.
• Ensures PFS departmental quality and productivity standards are met.
• Collects and provides patient and payer information to facilitate account resolution.
• Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission.
• Responds to all types of account inquiries through written, verbal, or electronic correspondence.
• Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third‑party payers.
• Responsible for professional and effective written and verbal communication with both internal and external customers.
• Meets or exceeds customer expectations and requirements, and gains customer trust and respect.
• Compliant with all CHRISTUS Health, payer, and government regulations.
• Exhibits a strong working knowledge of CPT, HCPCS, and ICD‑10 coding regulations and guidelines.
• Appropriately documents patient accounting host system or other systems utilized by PFS in accordance with policy and procedures.
• Provide continuous updates and information to the PFS Leadership Team regarding errors, issues, and trends related to activities affecting productivity, reimbursement, payment delays, and/or patient experience.
• Professional and effective written and verbal communication required.
• Billing:
  Review and work on claim edits.
• Work payor rejected claims for resubmission.
• Work reports and billing requests.
• Demonstrates strong knowledge of standard bill forms and filing requirements.
• Exhibits an understanding of electronic claims editing and submission capabilities.
• Correct claims in RTP status in the designated claim system per Medicare guidelines.
• Maintains an active knowledge of all governmental agency requirements and updates.
• Collections:
  Collect balances due from payors ensuring proper reimbursement for all services.
• Identify and forward proper account denial information to the designated departmental liaison.
• Dedicated efforts to ensure a proper denial resolution and timely turnaround.
• Works collector queue daily utilizing appropriate collection system and reports.
• Identify and resolve underpayments with the appropriate follow-up activities within payor timely guidelines.
• Identify and resolve credit balances with the appropriate follow-up activities within payor timely guidelines.
• Identify and communicate trends impacting account resolution.
• Initiates Medicare Redetermination, Reopening and/or Reconsideration as needed.
• Working knowledge of the CMS 838 credit balance report.
• Vendor Coordinator:
  Acts as liaison between external vendors and Revenue Cycle departments to monitor external vendor activities.
• Manages account transfers between CHRISTUS Health and the various contracted vendors.
• Coordinates with Revenue Cycle Managers (Collections, Billing, Cash Applications, etc.) to review of selected accounts prior to transfer and placement with an external third party.
• Ensures accounts deemed as closed or uncollectible by the vendors are properly reflected in applicable AR systems.
• Maintains department reports measuring agency performance, which includes account placements, collections,…