Patient Financial Services Representative - Part-time - 2 Days each week M-F 8a - 430p - Schedule TBD

Job Summary

Supports and is responsible for incorporating into job performance the Frederick Health (FH) mission vision core values and customer service philosophy and adheres to the FH Compliance Program including following all regulatory requirements and the FH Standards of Behavior.

The Patient Financial Service Rep ensures patient charges and payments are correct insurance authorization has been obtained and timely submission of the account to achieve payment from third party payer or the patient. Demonstrates a high level of accuracy considering the volume and filing requirements of the various insurance payers. Also recognizes the priorities of the work to be completed in order to maximize efficiency.

Example of Essential Functions:

• Examines denied and underpaid claims to determine reasons for discrepancies
• Communicates directly with payers to follow up on outstanding claims resolve payment variances and achieve timely reimbursement
• Provides payers with specific reasons for suspected underpayments and analyzes denial reasons given by payers
• Works with management to identify trend and address root causes of denials; helps pinpoint strategies for reducing A/R
• Maintains a thorough understanding of federal and state regulations as well as specific payer requirements and explanations of benefits in order to identify and report billing compliance issues and payer discrepancies
• Updates and maintains accurate files on each payer including contact names addresses phone numbers and other pertinent information; thoroughly documents all interactions with payers
• Effectively handles all communications including telephone and email from payers and departments within the business office
• Utilizes payer scorecards identifies highrisk accounts and prioritizes followup efforts
• Participates in continuous quality improvement efforts on an ongoing basis establishing goals with supervisors and tracking progress
• Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management
• Understands and maintains compliance with HIPAA guidelines when handling patient information
• Receives and processes all types of patient payments by properly documenting and entering transactions into the system; posts payment promptly
• Prepares individual bank deposits accurately and in a timely manner; checks with the bank for any direct deposits
• Prepares posts and processes payment batches; posts denials contractual adjustments and guarantor payments within payment batches; and ensures all payment batches are balanced
• Reconciles cash receipts and patient accounts
• Investigates the source of unidentified payments to ensure they are applied to appropriate accounts
• Identifies and examines underpayments to determine if additional payment can be pursued; follows up with payers and patients accordingly
• Identifies and examines unapplied credits and other overpayments to determine if a refund is necessary; issues refunds promptly as appropriate
• Records appropriate uptodate notes in patient accounts and provides insurance collectors accounts for followup
• Makes copies of all necessary EOBs for insurance carriers
• Analyzes EOB information including copays deductibles coinsurance contractual adjustments denials and more to verify accuracy of patient balances
• Reconciles shortages on both paper and electronic EOBs to determine proper allowance and correct writeoff
• Transfers balances to selfpay or secondary insurance
• Handles telephone questions and concerns from customers; ensures complaints and inquiries are recorded and reported to management
• Utilizes the safe to deposit large bills and sums of money from the cash drawer; keeps minimum allowable amount in drawer at all times
• Balances cash register/box daily or as instructed
• Demonstrates exceptional guest relations by promptly answering phone calls and answering patient questions
• Complies with all organizational policies regarding ethical business practices
• Performs other duties as assigned

Required Knowledge Skills and Abilities:

Strong analytics communication and organization skills and 40 wpm typing speed are required.

Minimum Education Training and Experience Required:

• High School diploma or GED is required.
• One year of experience working in a hospital or physician collections/centralized billing function is preferred.

Patient Contact

Must demonstrate and maintain current knowledge and skills in providing appropriate care/contact for patients in the following age groups:

Performance of job does not require patient contact

Physical Demands:

Sedentary Light Work Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting a certain amount of walking or standing is often necessary.

Ergonomic Risk Factors:

Repetition: Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated the speed of the movement the required force and muscles involved.

Awkward Posture: Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity. Awkward postures include repeated or prolonged reaching twisting bending kneeling squatting working overhead with your hands or arms or holding fixed positions.

Working Conditions:

A. Bloodborne Pathogens Exposure Risk: Category C NO exposure to blood or body fluids.

Reporting Relationship:

Reports to Supervisor Patient Accounting

Caring for you as you care for the CommUNITY
Frederick Health offers a comprehensive and affordable benefits package. Health Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your familys needs. Life insurance ShortTerm Income Replacement and LongTerm Disability are employer paid for eligible employees. Frederick Health offers a robust Paid Time Off program for eligible employees. Our 403B retirement plan helps you save for your retirement and includes an employer match to eligible employees. All employees have access to free financial planning sessions. We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.

Pay is based on experience skills and education. If position is parttime salary will be prorated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. NonExempt positions may have shift differential and/or Overtime paid if applicable.

Hourly Range: $17.80 25.60

Patient Financial Services
Parttime 32 Hours BiWeekly
Two Days each week
Monday Friday 8a 4:30
Schedule TBD

Required Experience:

Unclear Seniority