CHRISTUS Health ยท 7 hours ago
Patient Financial Specialist - Patient Financial Services
Irving, TX
Full-time
Onsite
Entry Level
1+ years expCHRISTUS Health is a healthcare organization seeking a Patient Financial Specialist for their Patient Financial Services division. The role involves supporting the Revenue Cycle by ensuring timely account resolution and reconciliation of outstanding patient balances while adhering to ethical standards and departmental guidelines.
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's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission. Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers. Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution
Meets or exceeds customer expectations and requirements, and gains customer trust and respect
Compliant with all CHRISTUS Health, payer, and government regulations
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
Provide continuous updates and information to the PFS Leadership Team regarding errors, issues, and trends related to activities affecting productivity, reimbursement, payment delays, and/or patient experience
Professional and effective written and verbal communication required
Billing
Review and work on claim edits
Works payor rejected claims for resubmission
Works reports and billing requests
Demonstrates strong knowledge of standard bill forms and filing requirements
Exhibits and understanding of electronic claims editing and submission capabilities
Correct claims in RTP status in the designated claim system per Medicare guidelines
Maintains an active knowledge of all governmental agency requirements and updates
Collections
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 with the appropriate follow-up activities within payor timely guidelines
Identify and resolve credit balances with the appropriate follow-up activities within payor timely guidelines
Identify and communicate trends impacting account resolution
Corrects claims in RTP status in the designated claim system per Medicare guidelines
Initiates Medicare Redetermination, Reopening and/or Reconsideration as needed
Working knowledge of the CMS 838 credit balance report
Vendor Coordinator
Acts as liaison between external vendors and Revenue Cycle departments to monitor external vendor activities and ensures accounts placed for collection are received timely and acknowledged as received by the vendor
Manages account transfers between CHRISTUS Health and the various contracted vendors
Coordinates with Revenue Cycle Managers (Collections, Billing, Cash Applications, etc.) to review of selected accounts prior to transfer and placement with an external third party
Ensures accounts deemed as closed or uncollectible by the vendors are properly reflected in applicable AR systems
Maintains department reports measuring agency performance, which includes account placements, collections, returns, and performance metrics
Advises vendors of CHRISTUS Health billing and collection procedures and ensures accounts identified with third-party coverage are properly billed by the entities as requested by the vendor
Audits all vendor remittances and ensures all fees billed to CHRISTUS Health are in accordance with the contract and include supporting documentation of payments posted to the account on the patient accounting systems
Recalls accounts incorrectly placed and/or as requested by Revenue Cycle Managers with the external vendor and returns accounts to open receivables as appropriate
Creates tools, reports, or documentation that enables Revenue Cycle Leadership to understand, manage, and measure their vendor's performance and to prioritize important relationships
Performs account reconciliation between CHRISTUS Health system and vendor system
Qualification
Required
HS Diploma or equivalent years of experience required
Preferred
Post HS education preferred
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment 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
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred
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 (36)
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