PFS Account Representative Level 1
PFS Account Representative Level 1
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Job Description
Ann & Robert H. Lurie Childrens Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence kids and their families are at the center of all we do. Ann & Robert H. Lurie Childrens Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.
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Job Description
Job Summary:
A Patient Financial Service (PFS) Account Representative works as the last stop on the Revenue Cycle of the hospital. Therefore he/she holds all upstream areas (from our registrars to our clinicians to our coding team) accountable if a breakdown were to occur or if pertinent information needed for billing is missing. A PFS representative is oftentimes the liaison between the hospital and the payer and is ultimately responsible for the reimbursement that is owed. The success of a PFS representative directly impacts and correlates to the hospitals bottom line and allows Lurie Childrens to fulfill our mission of serving children in need. Specifically a PFS representative serves as the main contact for all patient/families third parties and related Lurie Childrens departments analyzing and resolving all billing collection and customer inquiry needs. Responsible for the timely and accurate resolution of hospital accounts and the collection of reimbursement to maintain hospital operations. Routinely uses the patient accounting system electronic claims systems office software verbal and written skills to expedite resolution of claims and issues.
Job Duties:
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.
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.
Knowledge Skills and Abilities:
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.
Education
High School Diploma/GED (Required)Pay Range
$19.50-$30.23 HourlyAt Lurie Childrens we are committed to competitive and fair compensation aligned with market rates and internal equity reflecting individual contributions experience and expertise. 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 Childrens offer a comprehensive rewards package that may include differentials for some hourly employees leadership incentivesfor select roles health and retirement benefits and wellbeing programs. For more details on other compensation consult your recruiter or click the followinglink to learn more about our benefits.
Benefit Statement
For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:
Medical dental and vision insurance
Employer paid group term life and disability
Employer contribution toward Health Savings Account
Flexible Spending Accounts
Paid Time Off (PTO) Paid Holidays and Paid Parental Leave
403(b) with a 5% employer match
Various voluntary benefits:
Supplemental Life AD&D and Disability
Critical Illness Accident and Hospital Indemnity coverage
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 Childrens facilities
Discount purchasing program
Theres a Place for You with Us
At Lurie Childrens we embrace and celebrate building a team with a variety of backgrounds skills and viewpoints recognizing that different life experiences strengthen our workplace and the care we provide to the Chicago community and beyond. We treat everyone fairly appreciate differences and make meaningful connections that foster belonging. This is a place where you can be your best so we can give our best to the patients and families who trust us with their care.
Lurie Childrens and its affiliatesare equal employment opportunity employers. All qualified applicants will receive consideration for employment without regard to race color sex sexual orientation gender identity or expression religion national origin ancestry age disability marital status pregnancy protected veteran status order of protection status protected genetic information or any other characteristic protected by law.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
