Patient Financial Services Representative I - York - Days

Responsibilities

• Determines reasons for delayed or missing payments on patient accounts billed to insurance companies.
• Investigates denied or rejected claims, reviews insurance remittance advice, and identifies reasons for denial.
• Collaborates with insurance carriers, internal billing teams, and other stakeholders to obtain necessary information and documentation to resolve claims.
• Documents findings and actions taken to resolve denials or delays in payment.
• Initiates and manages appeals or resubmissions of denied claims as appropriate.
• Communicates effectively, verbally and in writing, directly with payors to follow up on outstanding claims, files technical and clinical appeals.
• Solves payment delays/non-payments to ensure timely and accurate reimbursement.
• Maintains accurate records of follow-up activities and payment status in the billing system.
• Identifies trends in denied claims and recommends process improvements to reduce denials and expedite payment.
• Provides excellent customer service to patients and internal teams regarding billing inquiries and insurance follow-up.

Qualifications

• High School Diploma or GED
• Prior experience in hospital billing, professional billing, or insurance follow-up/denials (preferred)
• Knowledge of insurance claims processing, payer policies, and medical terminology (essential)
• Strong analytical and problem-solving skills (essential)
• Excellent verbal and written communication skills (essential)
• Proficiency with billing software and Microsoft Office Suite (Excel, Word, Outlook) (essential)
• Ability to manage multiple accounts and prioritize tasks efficiently in a fast-paced environment (essential)
• Attention to detail and commitment to accuracy (essential)