CHRISTUS Health · 1 day ago
Patient Financial Specialist Senior - Patient Financial Services
Alamogordo, NM
Full-time
Onsite
Mid, Senior Level
3+ years expCHRISTUS Health is a healthcare organization focused on providing quality patient care. The Patient Financial Specialist Senior is responsible for ensuring account resolution and reconciliation of outstanding balances for patient accounts while supporting the Revenue Cycle division.
Hospital & Health Care
Responsibilities
Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health key performance metrics
Ensures PFS departmental quality and productivity standards are met
Functions as a subject matter expert in support of other PFS team members and other departments/facilities within the CHRISTUS Health network
Demonstrates a good understanding and has the ability to interact with the payer to verify coverage, submit claims, and follow up on appeals, underpayments, short pays or payment disputes for resolution
Investigate and resolve complex payment denials inclusive of correcting errors and supplying additional required information to facilitate collection of reimbursement / additional reimbursement
Ability to analyze, recognize, and resolve issues utilizing strategic thinking
Level of knowledge and the ability to work with a variety of payers
Adapt to process and procedure evaluations and improvements, support continuous change, and willingly manage special projects in addition to normal workload and other duties as assigned
Responsible for professional and effective written and verbal communication with both internal and external customers
Exhibits a strong working knowledge of CPT, HCPCS and ICD-10 coding regulations and guidelines
Appropriately documents patient accounting host system or other systems utilized by PFS in accordance with policy and procedures
Provides strategic business analysis updates and information to PFS Leaders and System Director regarding operational opportunities that affect reimbursement resulting in payment delays and/or loss of revenue
Must have in-depth knowledge and ability to maneuver efficiently through Patient Accounting Systems, Document Imaging, Databases, etc. Strong understanding of systems from an end-user and processing perspective
Must have understanding of Medicare and Commercial contract language
Must have good technical aptitude working with a variety of MS Office products (Word, Excel, PowerPoint, Outlook) and/or ability to learn and develop more advance skills with the various applications
Must have strong verbal and written communication skills. Ability to effectively and efficiently articulate ideas to team members and management in a timely manner
Must have good understanding of the various areas of government, non-government programs, billing, customer service and cash applications
General hospital A/R accounts knowledge is required
Works reports and requests from facility or other revenue cycle areas to identify and communicate trends impacting account resolution
Works and completes assigned collection insurance collection work queues on a daily basis which will include technical denials and at-risk claims
Reviews accounts to check for qualification for combining according to both government and non-government payer rules and regulations and combines accounts as required to maintain compliance
Identify, address, and communicate operational and financial risks
Resolve aged and/or problematic accounts
Utilize multiple reporting systems
Collect balances due from payors ensuring proper reimbursement for all services
Identifies and forwards proper account denial information to the designated departmental liaison. Dedicated efforts to ensure a proper denial resolution and timely turnaround
Maintain an active knowledge of all governmental agency requirements and updates
Works collector queue daily utilizing appropriate collection system and reports
Demonstrates knowledge of standard bill forms and filing requirements
Identify and resolve underpayments and credit balances with the appropriate follow-up activities within payor timely guidelines
Initiates Medicare Redetermination, Reopening and/or Reconsideration as needed
Works reports and requests from the facility or other revenue cycle areas
Reviews accounts to check for qualification for combining according to both government and non-government payer rules and regulations and combines accounts as required to maintain compliance
Works unbilled and failed claim reports to resolve claim checks in the Patient Accounting host system
Demonstrates strong knowledge of standard bill forms and filing requirements
Exhibits and understanding of electronic claims editing and submission capabilities
Identify and communicate trends impacting account resolution
Maintains an active working knowledge and ability to perform necessary research of Government and Non-Government Regulations as it pertains to claims submission
Qualification
Required
HS Diploma or equivalent years of experience required
Experience calculating expected reimbursement according to payer regulations and/or contracts required
Experience with Commercial, Medicare, and Medicaid reimbursement
Preferred
Post HS education preferred
3-5 years of experience preferred
Medicare, Medicaid, VA, Tricare billing and collections processes and regulations preferred
College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience
Prefer hands-on experience with Medicare Remote (FISS) – DDE
Company
CHRISTUS Health
CHRISTUS Health is a Catholic not-for-profit health care system comprising more than 600 centers, including long-term care facilities, community hospitals, walk-in clinics and health ministries.
10001+ employees
H1B Sponsorship
CHRISTUS Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (43)
2024 (35)
2023 (54)
2022 (46)
2021 (22)
2020 (26)
Funding
Current Stage
Late StageLeadership Team
Terry Kyle
CEO and CDO The Children's Hospital of San Antonio Foundation & Friends of CHRISTUS Santa Rosa Fnd
Thomas Royer, MD
CEO Emeritus
Company data provided by crunchbase