Children's Hospital of Philadelphia · 9 hours ago
Patient Financial Services - Associate II
Philadelphia, PA
Full-time
Hybrid
Entry Level
$27.35/hr - $34.19/hr
2+ years expChildren’s Hospital of Philadelphia (CHOP) is seeking a Patient Financial Services Associate II to support its financial health while enhancing patient care. The role involves analyzing denied claims, leading appeal efforts, and verifying patient coverage to ensure accurate reimbursement, contributing to the revenue cycle and overall operational efficiency.
Child CareHealth CareHospitalMedicalNon Profit
Responsibilities
Submits timely, accurate claims to insurance carriers according to insurance payor guidelines through established methods and procedures using current available technology
Resolve patient insurance balances by analyzing denials and using critical thinking skills and knowledge of payer requirements to determine the steps needed to obtain payment. Work in either No Pay No Response, Denial work queues, or both
Based on payer processes, utilize payer portals, paper/electronic remits and/or place calls to the payer to understand and resolve denials
Perform adjustments as needed
Ability to manage daily job functions along with special project work and prioritize level of importance on demand
Identifying third party payor response trending and escalation to management team as deemed necessary
Reviewing data sets CPT-codes, IDC-10 codes, HCPCS codes, coordination of benefits, registration discrepancies, third party payer rules, and payer contracts
Prioritize assigned work based on department needs and direction from leadership team
Follow workflows to route accounts to other CHOP departments (Case Management, Medical Records, Credit Resolution, Billing, Abstraction, Clinical Teams, Coding etc.) to address denials
Advise supervisor of contractual issues as discovered
Place phone calls, sends email or written communication to families to resolve denials that require intervention from the guarantor
Document each account thoroughly, explaining action taken on the account and completing note template provided
Gather Medical Records, using ROI, to assist in resolving denials as needed
Files appeals on behalf of the patient to resolve denials. Reviews and acts on correspondence for assigned accounts
Position requires adherence to production and quality metrics
Identifies trends in assigned work queues and reports to leadership
Works accounts holistically, building on the last intervention and not repeating tasks
Identifies patients with multiple denials and works from a guarantor level to resolve issues completely for a family
Completes projects as assigned for specific payers or specific types of accounts, ensuring deadlines are met
Excellent oral and written communication skills with strong analytical skills
Suggests ideas and solutions for performance and quality improvement and provides feedback to team leaders
Responsible for full comprehension of CHOP revenue cycle work design including registration, billing, payment posting, account receivable follow-up, and compliance actions
Demonstrates quality and effectiveness in work habits in every interaction with colleagues and leadership
Provides training as assigned to new employees, as well as cross training
Interfaces well with all levels of staff and management
Meets established daily/weekly reasonable work expectation of productivity and quality requirements
Maintains all PHI in accordance with HIPPA, JACHO, third party contractual agreements along with CHOP policy and procedures
Demonstrates behaviors that are consistent with CHOP’s organizational values of Integrity, Compassion, Accountability, Respect and Excellence (ICARE). Ensures work is performed, relationships are built, responsibility is assumed, and service delivered expresses the CHOP’s values through action
Ability to communicate effectively and collaborate with teams across Patient Financial Services and other departments around operational efficiencies. Provide recommendations for corrective action to management team to ensure efficiency of the revenue cycle
Reports safety hazards, accidents and incidents, and unsafe working conditions promptly
Consistently supports compliance by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations
Other duties as assigned within the scope of the responsibilities
Qualification
Required
High School Diploma / GED - Required
At least two (2) years experience in billing, payment posting, operations, or related role - Required
HIPAA compliance standards (Required proficiency)
Effective communication, interpersonal skills, analytical skills, and problem solving skills. (Required proficiency)
Excellent organizational and time management skills. (Required proficiency)
Detail and results oriented. (Required proficiency)
High aptitude for math. (Required proficiency)
Excellent writing and oral communication skills. (Required proficiency)
Ability to work independently and prioritize work. (Required proficiency)
Basic Computer skills (Required proficiency)
High proficiency in Microsoft Excel. (Required proficiency)
Demonstrated customer service skills, customer focus abilities and the ability to understand Children's Hospital of Philadelphia customer needs. (Required proficiency)
Must maintain high-level knowledge of claim submission requirements. (Required proficiency)
Ability to work cooperatively in a team environment. (Required proficiency)
Demonstrated effective interpersonal, verbal, and written communication skills. (Required proficiency)
Knowledge of Microsoft Office applications including Word, Excel. (Required proficiency)
Must have 10-key by touch. (Required proficiency)
Demonstrated experience with multiple computer applications. (Required proficiency)
Experience in using commonly used electronic health records and healthcare revenue cycle financial management systems. (Required proficiency)
Preferred
Bachelor's Degree - Preferred
At least three (3) years experience in billing, payment posting, operations, or related role - Preferred
Knowledge of third-party reimbursement and physician/hospital billing. (Preferred proficiency)
Experience in using commonly used electronic health records and healthcare revenue cycle financial management systems. (Preferred proficiency)
Experience with Epic systems (Preferred proficiency)
Benefits
Complimentary Healthcare Financial Management Association (HFMA) membership
Leadership development
Professional learning opportunities
Long-term career advancement
Enterprise-wide volunteer opportunities
Patient-focused initiatives
Company
Children's Hospital of Philadelphia
Since its start in 1855 as the nation's first hospital devoted exclusively to caring for children, The Children's Hospital of Philadelphia has been the birthplace for many dramatic firsts in pediatric medicine.
10001+ employees
H1B Sponsorship
Children's Hospital of Philadelphia 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 (175)
2024 (170)
2023 (140)
2022 (115)
2021 (70)
2020 (53)
Funding
Current Stage
Late StageTotal Funding
$33.35MKey Investors
UnitedHealthcare Community PlanNational Cancer InstituteBill & Melinda Gates Foundation
2025-12-10Grant· $1.7M
2025-09-29Grant· $1M
2025-06-18Grant· $1M
Leadership Team
Ron Keren
Senior Vice President and Chief Medical Officer
Adam Resnick
Director of the Center for Data Driven Discovery in Biomedicine (D3b)
Recent News
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