WhidbeyHealth · 2 hours ago
PFS Representative Billing and Collecting
Coupeville, WA
Full-time
Onsite
Entry Level
$21.58/hr - $39.71/hr
1+ years expWhidbeyHealth is dedicated to providing quality healthcare, and they are seeking a Patient Financial Services Representative to support the financial health of the organization. The role involves coordinating patient referrals, verifying insurance, providing financial counseling, and managing billing and collection processes for both insurance and self-pay accounts.
Hospital & Health Care
Responsibilities
Coordinates patients through referral and follow-up care by scheduling with appropriate specialists, facilities, agencies and insurance companies
Ensures that appropriate and timely follow up is provided to the patient, while documenting all patient referral information in a manner that is clear and understandable by staff
Requests appropriate copies of chart notes, laboratory results, radiology images, patient history and disseminates that information to the designated referral sources and monitors progress
Provides updates to department staff when there are changes in referral procedures, laws and insurance requirements that would affect the patients’ care plan
Works as an integral part of the care team, coordinating needs and patient progress with providers and other designated staff members, to ensure a cohesive and seamless referral experience for the patient and patient’s family
Completes all forms according to department and governmental guidelines
Scans all documentation into the patient’s electronic medical record
Maintains a comprehensive filing system that clearly identifies and updates all forms used in the referral process. Provides timely creation, updates, and corrections to forms as needed
May be required to provide back up to the Patient Registrar or HIM Technician on as needed basis to support department or clinic functions
Contacts insurance companies on preadmissions and admissions, verifying eligibility and benefits for patients
Notifies the Financial Advocate and/or service department or clinic of patients who do not have appropriate referrals and authorizations in place
Documents contact person name, eligibility, benefits, referrals, authorization, and any other pertinent information in notes
Obtains patient signatures on messages from Medicare and Tricare
Maintains insurance notebook on different payer requirements
Acts as an insurance resource to other departments and provides training in the use of eligibility resources
Reviews department schedules and identifies patients not yet pre-admitted for pending services. Contacts and interviews patients by phone that have not had services within the past 90 days, obtaining demographic and insurance information
May be required to provide back up to the Patient Registrar or Financial Advocate on an as needed basis to support department functions
Interviews and provides financial counseling to all patients regarding patient balances
Arranges for the resolutions of patient liabilities through valid financial arrangements
Assists and advises patient in obtaining alternative financial resources in order to meet their obligation including bank loans, DSHS programs and financial assistance
Identifies patients for COBRA and follows through for approval
Obtains necessary release signatures, ensuring confidential signatures are obtained
Completes indicator reports on a timely basis
Provides price quotes when requested by patients
May be required provide back up to the Insurance Verifier or Patient Registrar on an as needed basis to support department functions
Electronically and manually bills all accounts timely, to include but not limited to insurance and self-pay accounts
Follows up on all requests for additional information from the insurance company within established department productivity standards
Follows up with the insurance company to ensure payment within established department productivity standards
Contacts the patient or guarantor for further information to collect on the account or to resolve the account
Accepts payments made over the phone from patient or guarantor
Processes refunds to patient, guarantor, or insurance company as required
Promptly posts payments to accounts through DDE and electronically
Works closely with Third Party Payers, Collection Agencies, and Attorneys as needed
Understands and can articulate financial assistance policy to the patient or guarantor
Works through daily Queue and reports within established target levels for department productivity
Reviews accounts and remittance to ensure correct payment
Pulls insurance remits and patient payment back up for rebilling, refunds, and audits
Inputs statistically numbers in online reports
Prepares insurance appeals and follows up as required
Processes technical denials
Maintains the Itemized Statement Request Line
Reviews First Choice invoice and Pacific Medicaid invoice to ensure proper billing prior to sending for payment request. Identifies and resolves any errors
Completes financial rounding with IP/OBS patients to review patient’s financial responsibility after insurance coverage or if full self-pay
Provides prompt and courteous service to all visitors and callers to the Patient Financial Services department. Resolves accounts or inquiries or identifies and transfers to the appropriate party to assist further
Qualification
Required
High school diploma or equivalent required
One (1) year of previous related experience in a medical front office
Knowledge of medical terminology, including terminology use in regards to insurance, inpatient and outpatient billing and coding
Knowledge of various governmental agency and insurance requirements
Must have the ability to be highly organized and multi-task at various work stations and settings
Must possess effective professional interpersonal skills as well as excellent service skills in all interactions with the ability to communicate effectively on the phone, in person and in writing
Must be able to plan, prioritize and organize work assigned within communicated deadlines
Must demonstrate an attention to detail when completing all work assigned
Preferred
Advanced education preferred
Previous experience with billing and collections in a medical office or hospital setting strongly preferred
Certified Revenue Cycle Specialist (CRCS) certification preferred
Certified Healthcare Access Associate (CHAA) certification is acceptable for PFS Representatives working in Patient Referrals, Insurance Verifier or Financial Advocate roles
Company
WhidbeyHealth
WhidbeyHealth Medical Center and clinics are operated by the Whidbey Island Public District Hospital, which is dedicated to providing exceptional care with compassion and respect.
501-1000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase