Patient Financial Services Representative III

Fairview is looking to hire a Patient Financial Services (PFS) Representative III to join our Revenue Cycle team! This is a full-time, 1.0 FTE (80 hours per two-week pay period), benefit-eligible position working Monday through Friday, 8 hours per day, with home-based flexibility.

As a PFS Representative III, you will be responsible for managing complex accounts receivable, insurance follow-up, and resolving outstanding claims to ensure accurate and timely reimbursement. This position focuses specifically on Special Guarantor accounts, working with unique payers and specialized billing requirements. Responsibilities include researching account discrepancies, resolving denials, communicating with payers, and collaborating with internal teams to ensure accounts are appropriately resolved.

The ideal candidate will have previous healthcare billing and insurance follow-up experience, strong working knowledge of Epic, and the ability to navigate complex payer requirements. Familiarity with Special Guarantor accounts is highly preferred, and experience with professional claims billing and follow-up is a plus. Strong organizational skills, attention to detail, and the ability to work independently while meeting productivity and quality expectations are essential.

This position is responsible for billing and collection of accounts receivable for inpatient and outpatient accounts, ensures expected payment is collected and accounts are fully resolved, and resolves complex customer service issues. This position understands the importance of evaluating and securing all appropriate financial resources for patients to ensure proper adjudication.

• Intentionally prevents untimely revenue shortfalls by taking action to resolve financial transactions appropriately and effectively to ensure collection of expected payment; escalates issues when appropriate.
• Completes daily work assignment timely and accurately in accordance with the identified productivity and quality standards set forth by the organization.
• Performs the best practice routine per department guidelines.
• Proactively looks for continuous process improvements involving people and technologies through tracking, trending, and providing feedback.
• Accelerates business outcomes by identifying ways to fully resolve accounts through single-touch resolution when possible.
• Understands revenue cycle and the importance of evaluating and securing all appropriate reimbursements from insurance or patients.
• Contacts payers via portal or provider service center to facilitate timely and accurate resolution of accounts.
• Responsible for processing external correspondence in a timely and efficient manner.
• Ensures internal correspondence is clearly and professionally communicated and processed expeditiously.
• Responsible for verification of insurance and/or patient demographics
• Understands expected payment amounts and Epic expected payment calculations to appropriately adjust accounts.
• Educates patients and/or guarantors of patient liability when appropriate.
• Understands and complies with all relevant laws, regulations, payer and internal policies, procedures, and standards, and applies this understanding through daily work
• Responsible for processing accounts through multiple workflows
• Responsible for working accounts requiring more attention to detail
• Advanced knowledge of team procedures, standards, and policies, and applies this knowledge through daily work.
• Makes appropriate contacts with payers and other necessary parties to obtain and/or provide data or information needed to facilitate timely and accurate account resolution to expedite outcomes.
• Utilizes strong understanding of multiple systems/applications to ensure collection of expected payment.
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