-Performs Medical collection functions relevant to the Patient Financial Services Department in a manner that meets or exceeds CHRISTUS Health key performance criteria as it relates to cash collections, aged accounts receivables and denials.
-Contact will be made with payers through written correspondence, on-line inquiries or phone to obtain claim status, clarification or to escalate resolution of patient accounts. Exhibits excellent verbal and written communication skills.
- Responsible for researching and resolving accounts. Review proper account handling from admission through self pay collections and applies corrective actions as necessary.
-Understanding of insurance denials and underpayments and routes account to proper department for assistance in resolution. Exhibits excellent problem solving skills.
-Reviews account payment for accuracy utilizing an insurance explanation of benefits, on-line resources or contracts. Determines if balance should be moved to the next responsibility party. Able to resolve credit balances by determining if an account is overpaid or over adjusted.
-Ensures proper reimbursement for all services. All appeals and/or refunds are filed timely in accordance with payer regulations or contracts.
-Responsible to contact CHRISTUS Health facility departments in order to resolve outstanding questions related to account or charge posting information to ensure account integrity and compliance with payer and/or government regulations and to ensure timeliness of follow-up activities.
-Performs rebilling functions as appropriate and exhibits knowledge of UB04 and 1500 bill forms and filing requirements. Exhibits an understanding of CPT, HCPCS and ICD-10 coding regulations and guidelines.
-Understands state insurance laws and the various appeals processes including but not limited to Insurance Commission filings.
-Ensures quality and productivity standards are met. Appropriately documents patient accounting host system or other systems utilized by Patient Financial Services in accordance with policy and procedures.
- Provides continuous updates and information to Patient Financial Services Leadership Team regarding ongoing errors, payer related issues/trends, registration and other controllable QA related activities affecting productivity, reimbursement and/or payment delays.
- Maintains thorough and detailed knowledge of state and federal collection laws, third-party payer claims processing and appeal procedures as well as the different payment methodologies. Ensures compliance with state and federal laws regarding all cash collections activities.
-Functions as a subject matter expert in assisting facility and other Patient Financial Service associates with account and payer related questions.
- Functions effectively within a team and participates and contributes constructively to produce results in a cooperative effort.
-Continually seeks to understand and act upon customer needs, concerns, and priorities. Meets customer expectations and requirements, and gains customer trust and respect.
- Demonstrates ongoing enthusiasm and commitment to the work assigned.
-Works with Supervisor to receive feedback on performance and create a personal development plan.
Our Mission: WHY WE EXIST. To extend the healing ministry of Jesus Christ. Our Core Values: WHAT WE BELIEVE IN.DIGNITY Respect for the worth of every person, recognition and commitment to the value of diverse individuals and perspectives, and special concern for the poor and underserved. INTEGRITY Honesty, justice, and consistency in all relationships. EXCELLENCE High standards of service and per...formance. COMPASSION Service in a spirit of empathy, love, and concern. STEWARDSHIP Wise and just use of talents and resources in a collaborative manner.Our Vision: WHAT WE ARE STRIVING TO DO. CHRISTUS HEALTH, a Catholic health ministry, will be a leader, a partner and an advocate in the creation of innovative health and wellness solutions that improve the lives of individuals and communities so that all may experience God's healing presence and love. Our Name and Symbol:WHO WE ARE. CHRISTUS is Latin for "Christ," and proclaims publicly the core of our mission. OUR NAME choice also recognizes the heritage of our two congregational sponsors, the Sisters of Charity of the Incarnate Word in Houston and San Antonio. Jesus Christ is the Incarnate Word, the Word of God made flesh. It is, therefore, only fitting that it is in another form of His name that our health ministries are called together. OUR SYMBOL Reflects the healing ministry of Jesus Christ - a combination of a medical cross and a religious cross. The flowing banner on the cross is a common symbol of the risen Christ, while the royal purple signifies Christ. The flowing banner also conveys a sense of motion as we move forward into a new era of service to our communities.
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