Patient Financial Services Account Representative- Hybrid schedule

About the role

A Patient Financial Service (PFS) Account Representative works as the last stop on the Revenue Cycle of the hospital. He/she holds all upstream areas accountable if a breakdown were to occur, or if pertinent information needed for billing is missing. This role is often the liaison between the hospital and the payer and is ultimately responsible for the reimbursement that is owed.

Responsibilities

• Create and submit all billing to Government entities, private insurance payers and families; consistent with Federal, State and insurance specific requirements.
• Resolve all assigned claim edits generated by Epic, the clearinghouse or the payor.
• Develop strategy to reduce claim edits by collaborating with management and other departments.
• Identifies Registration, Demographic and Insurance information problems makes all necessary updates. This includes eligibility verification and referral retrieval.
• Resolve assigned denials and variances, accurately determining the root cause and collaborating to reduce the denial or variance.
• Ensure that all claims issued timely and are received by the payers.
• Routinely uses the patient accounting system, electronic claims systems, office software, verbal and written skills to expedite resolution of claims and issues.
• Process assigned inbound correspondence and telephone inquiries from patients and insurance carriers. Promptly responding in writing or verbally. This includes researching and processing of charge revisions, corrections, adjustments, discounts associated with disputes.
• Process internal payment transfers between Hospital and Patient Billing, process refund requests for families, governmental and third-party payors.
• Interacts with Health Information Management, Case Management on claim submission issues which can include obtaining the appropriate Medical Record, or validation of coding.
• Other job functions as assigned.

Requirements

• High school graduate required; BS, BA, or CHAA preferred.
• Minimum 6 months experience in healthcare, hospital, clinics, or physician office environment preferred.
• Knowledge of ICD-10 coding, medical terminology, third party billing and collections, and managed care requirements.
• Excellent communication/listening skills.
• Ability to make quick, accurate decisions on a daily basis.
• Ability to handle stressful situations.
• Proficient computer skills and aptitude, Microsoft Office mandatory, Advanced Excel preferred.
• Substantial interpersonal skills sufficient to work effectively with pediatric patients, families, physicians, nursing, other allied health professionals, insurance professionals and administration.
• Problem solving ability and able to handle multiple priorities.
• Thorough knowledge of patient accounting, third party payer procedures, governmental regulations and managed care contracting to be effectively proactive in the billing and collection process, and to respond to inquiries on patient accounts in a customer satisfaction manner.

Qualifications

• High School Diploma/GED (Required)

Skills

• Knowledge of ICD-10 coding, medical terminology, third party billing and collections, and managed care requirements.
• Excellent communication/listening skills.
• Ability to make quick, accurate decisions on a daily basis.
• Ability to handle stressful situations.
• Proficient computer skills and aptitude, Microsoft Office mandatory, Advanced Excel preferred.
• Substantial interpersonal skills sufficient to work effectively with pediatric patients, families, physicians, nursing, other allied health professionals, insurance professionals and administration.
• Problem solving ability and able to handle multiple priorities.
• Thorough knowledge of patient accounting, third party payer procedures, governmental regulations and managed care contracting to be effectively proactive in the billing and collection process, and to respond to inquiries on patient accounts in a customer satisfaction manner.

Benefits

Lurie Children’s offers a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link to learn more about our benefits.

• Medical, dental and vision insurance
• Employer paid group term life and disability
• Employer contribution toward Health Savings Account
• Paid Time Off (PTO), Paid Holidays and Paid Parental Leave
• 403(b) with a 5% employer match
• Voluntary Benefits
• Tuition assistance
• Student loan servicing and support
• Adoption benefits
• Backup Childcare and Eldercare
• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
• Discount on services at Lurie Children’s facilities
• Discount purchasing program

Pay

The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children’s offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs.

Schedule

Hybrid Schedule: 3 days remote, 2 days on site
Hrs: 7:30 AM – 4:00 PM (flexible)