Lead Patient Financial Services Representative

Location: Valentine, NE 69201

About the role

The Patient Financial Services Representative performs a variety of routine and non-routine clerical/patient accounting functions in accordance with standard procedures in one or more of the following areas: patient accounting, accounts receivable, or hospital revenue cycle for the Cherry County Hospital and Clinic.

Responsibilities

• Works daily electronic billing file and submits insurance claims to third-party payers
• Posts monies received from all payor types (including Medicare, Medicaid, Managed Care, HMO, PPO, and patient)
• Accurate billing of patient accounts, ensuring timely claim submission and reimbursement from various third-party payers and patients
• Ensures proper account documentation in the facility's billing system and pursues follow-up efforts on aged accounts
• Reviews, evaluates, and forwards manual patient account statements to payers that do not accept electronic claims or require special handling
• Documents billing activity on the patient account; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to CFO
• Reviews claims for accuracy and coordinates with ancillary departments as needed to provide information for audits and/or record reviews
• Makes appropriate corrections based on electronic payers' error reports to optimize the electronic claims submission process
• Ensures payments and adjustments are accurately posted to patient accounts
• Ensures payments are logged correctly in the computer system to assure accurate patient statements
• Responds to written/oral requests for itemized bills from patients, insurance companies, and attorneys
• Researches all patient and insurance refunds in accordance with best practices and compliance benchmarks
• Calls patients to collect on outstanding balances, collect insurance information, or provide payment options
• Responds to patient inquiries regarding the status of insurance claims or balances due
• Visits patients in the Emergency Department or hospital to obtain information for billing or provider Medicaid application
• Reviews outstanding patient balances prior to elective services to secure appropriate payment arrangements
• Ensures timely resolution of credits by accurate and timely refunds to the appropriate entities and patients
• Prepares daily deposit and control sheets
• Sorts and distributes mail to the appropriate area/person
• Obtains pre-authorizations for services/procedures when required by the patient’s payor
• Posts charges onto the patient account for supplies and services provided to ensure proper billing and reimbursement
• Handles various reporting and miscellaneous tasks relating to Revenue Cycle functionality, Accounts Payable, or Timekeeping
• Ensures the confidentiality of patients’ medical, personal, and financial records is maintained
• Complies with Cherry County Hospital personnel policies and Corporate Compliance policies and procedures
• Performs other duties as assigned by the supervisor

Lead Duties

• Oversee day-to-day operations of the department
• Delegate tasks and set deadlines
• Set clear team goals
• Participate in recruitment and selection of team members
• Train new team members and monitor their accuracy and productivity
• Motivate and coach team members
• Identify training needs and provide coaching
• Resolve conflict; escalating as appropriate
• Provides feedback regarding job performance for team performance evaluations
• Serve as an effective role model, supporting department and organization changes
• Foster an open communication culture and inspiring team environment

Requirements

• High School diploma required
• 1 to 3 years of customer service and/or business office experience, ideally in a medical setting preferred
• Prior experience and knowledge in the use of software packages such as Microsoft Excel, Word, and Windows
• Knowledge of collection laws, 3rd party reimbursement, and basic hospital accounting

Benefits

• Supportive team environment
• Meaningful work that helps keep patient care running smoothly
• Opportunities for learning and professional growth
• Competitive pay and benefits

Pay

Starting at $35.10 per hour

Schedule

Full-Time, Benefit Eligible