Senior PFS Representative

Overview

M Health Fairview's Revenue Cycle Department has a new work from home opportunity. We have an opportunity for a Senior Patient Financial Services (PFS) Representative to join our DME Billing Team! This position is responsible for billing and collection of accounts receivable for inpatient and outpatient accounts, ensures expected payment is collected and accounts are fully resolved, and resolves complex customer service issues. This position understands the importance of evaluating and securing all appropriate financial resources for patients to ensure proper adjudication.

This opportunity is fully benefit eligible. Our benefits package includes medical, dental, and vision coverage. We encourage staff development and support continuing education. This is a work from home position, day shift only, exclusively on weekdays. It is a 1.0 FTE (80 hours per 2 weeks).

Interview Process

We may send you a link to complete a video interview. This is an outstanding way to showcase who you are and why you want to work for us plus we have the ability to share it directly with our leaders!

Responsibilities Job Description

Follow-up/Billing

Dependent on knowing denial/rejection codes, insurance guidelines and compliance

Customer service (mini call center)

Maintains the best practice routine per department guidelines.

Dependent on knowledge of phones, insurance guidelines, collection processes, personal skills for dealing with customer, Self-pay/Collections de-escalations tactics, payment research

Timely processing and follow-up of patient requests for payment research, checking charges, insurance processing concerns.

Work independently in problem solving with patients regarding their account.

Demonstrate a high degree of proficiency in billing and/or collection of multiple payers (both government and non-government) billing and collection practices.

Responsible for the analysis and processing of correspondence including rejections, requests for medical records, itemized bills, clarification of detail on bill, etc. Analyze paid claims for accuracy of payments and or rejections and properly account for payment and adjustments by both payers and patients.

Reviews explanation of benefits for accuracy in posting and assisting patients in understanding their patient liability.

Identify problem accounts and work towards timely resolution.

Communicate effectively via the telephone or written communication with patients or departments to obtain and provide all information for payers to process and pay claims quickly and accurately.

Bad debt management of accounts and interactions with vendors.

Counsel patients throughout the collection process on solutions available to them for account resolution.

Problem solve with vendors and patient on reasonable resolutions.

Refunds - dependent on use of Onbase

Patient Insurance

Confirming of sales orders (100% quality review) - Dependent on payor guidelines, compliance, and knowledge of equipment

Authorizations - Dependent on payor guidelines

Verifications - Dependent on Onesource (Experian), payor portal

Qualifications

Required

Experience

2 years in a medical billing office setting or relevant experience

Detail oriented

Ability to problem solve and able to utilize resources independently

Preferred

Education

High school graduate or equivalent

Experience

Durable Medical Equipment billing and follow up experience

Medical terminology

Knowledge of insurance processing and/or understanding of explanation of benefits

Coordination of benefits process

Knowledge of various systems (Brightree, EPIC, OnBase, etc.)

Knowledge of ICD-10 coding.

Ability to work independently.

Ability to adapt with rapid changes.

A quick learner who can retain various payor billing criteria consistently.

Microsoft Office 365

EEO Statement

EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status