WellSpan Health · 19 hours ago
Patient Financial Services Representative II - Days
Leola, PA
Full-time
Onsite
Entry, Mid Level
2+ years expWellSpan Health is an integrated delivery system focused on delivering comprehensive health and wellness solutions. They are seeking a Patient Financial Services Representative II to complete assigned revenue cycle tasks, assist coworkers, and perform various functions related to billing and insurance claims.
Health CareHospitalMedical
Responsibilities
Performs various functions to complete and expedite the billing process including:
Reviews and submits Hospital and/or Physician claim forms (UB04, 1500, etc) to insurance companies via electronic or manual processes and facilitates special billing for split claims, ancillary charges, interim bills, etc
Resolves Claim edits to facilitate timely billing and reimbursement
Performs follow-up with insurance companies to obtain claim status, payment and to resolve claim discrepancies
Submits itemized bills, medical records, and corrected claims as needed
Reviews remittance advice (835) to ensure proper reimbursement
Interacts directly with department staff, Revenue Integrity, HIM and payer representatives to resolve line level denials
Provides trend analysis to management, leadership, and insurance liaison
Writes and submits appeals when needed to overturn claim denials
Accesses external payer sites for payer policies, claim investigations, and claim disputes
Reviews accounts and coordinates with appropriate departments on accounts requiring precertification, preauthorization, referral forms, coding and other requirements related to ensuring claim payment
Updates financial and demographic information that may have been incorrectly entered into the billing system
Reviews accounts and makes written and/or verbal inquiries to third party payers to reconcile patient accounts. Follows up on accounts until outstanding insurance balance is zero
Reviews third party payer payments and investigates accounts not paid as expected. Takes appropriate corrective action to include follow up, rebilling, and/or adjustment of contractual allowances
Researches and works underpayment or overpayment as appropriate and works with Credits/Refunds or PRA team for refunds to third party payer per state / federal regulations or contract terms
Assists Team Lead and Supervisor with onboarding and training new staff, as requested
Works to resolve billing problems and/or receives insurance updates and acts as a first line of support to PFS I billing staff in resolving billing issues
Identifies trends, quantifies impact, and escalates as appropriate for resolution
Acts as a Team Lead in the absence of one
Assumes responsibility to lead projects as requested; may also lead process improvement initiatives for the department
Documents claim issues, root cause, action taken, and next steps planned in billing system
Maintains department records, reports, files as required
Maintains established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards
Participates in educational programs and in-service meetings
Provides outstanding service to all; fosters teamwork; embraces positive change and practices fiscal responsibility through improvement and innovation
Qualification
Required
High School Diploma or GED Required
2 years Experience in Healthcare Revenue Cycle, Patient Financial Services and/or Billing. Required
Certified Revenue Cycle Professional within 1 year Required
Certified Revenue Cycle Representative within 1 year Required
Certified Revenue Cycle Specialist within 1 year Required
Certified Patient Accounts Manager within 1 year Required
Certified Coding Associate within 1 year Required
Certified Coding Specialist within 1 year Required
Certified Coding Specialist - Physician Based within 1 year Required
Certified Healthcare Financial Professional within 1 year Required
Certified Outpatient Coder within 1 year Required
Certified Professional Coder within 1 year Required
Certified Professional Coder Apprentice within 1 year Required
Excellent communication and interpersonal skills
Familiarity with ICD-10 and CPT codes
Strong knowledge of payer rules and policies
Proficiency in claims editing software (SSI & Inovalon) and healthcare billing systems (Epic preferred)
Working knowledge of medical terms to help interpret edit resolution, claims remittance advice, medical record documentation and payer medical/payment policies
Benefits
Comprehensive health benefits
Flexible spending and health savings accounts
Retirement savings plan
Paid time off (PTO)
Short-term disability
Education assistance
Financial education and support, including DailyPay
Wellness and Wellbeing programs
Caregiver support via Wellthy
Childcare referral service via Wellthy
Company
WellSpan Health
WellSpan Health is an integrated health system that serves the communities of central Pennsylvania.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
W
William White
Vice President of Public Safety
Recent News
2026-01-09
2025-12-18
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