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Banner Health Patient Financial Services Representative - Claims Representative - Hybrid Remote Options in Phoenix, Arizona

Primary City/State:

Phoenix, Arizona

Department Name:

Work Shift:

Day

Job Category:

Revenue Cycle

Find your path in health care. We want to change the lives of those in our care – and the people who choose to take on this challenge. If you’re ready to change lives, we want to hear from you.

Banner Health currently has openings for Patient Financial Services (PFS) Representatives.

The Patient Financial Services (PFS) department includes:

  • Commercial Insurance/Contracts Division

  • AHCCCS, Blue Cross, Tricare, VA, Work Comp and Audits Division

  • Medicare/Medicare Advantage Division

The PFS Department is responsible for the timely and accurate billing and collections of revenue based on CMS guidelines, payer contracts and federal regulations. We strive to create an environment that engages employees to produce at the highest level and recognition for their accomplishments. All individual and team work assignments are designed to collectively meet Banner’s goals emphasizing excellent customer service and making a difference in our customer’s lives.

PFS Representative Day to Day Responsibilities:

PFS Representatives are responsible for accurate billing of services rendered, timely and accurate collection of expected reimbursement. Once the payer has satisfied the expected reimbursement any patient responsibility balance is billed to the patient. These functions are accomplished by:

  • Review of Initial claims to ensure clean claim submission

  • Review and follow up on billed claims to investigate reason for payment delays or denials by contacting the payer or researching the payer website

  • Calling payers to verify receipt of claims, what is needed to resolve unpaid accounts, short paid claims and/or other complex denials

  • Take incoming calls from patients to assist with resolving their Commercial Insurance questions as well as self-pay balances

  • Clear documentation of all work activity in the Ms4 account to ensure continuity throughout the entire revenue cycle

Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.

Please note: This is a requisition for various Patient Financial Services Representative positions that are open at the Banner Corporate - Phoenix. During the application process, you will have the opportunity to apply to multiple positions attached to this requisition. Applicants will be considered accordingly.

POSITION SUMMARY

This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner.

CORE FUNCTIONS

  1. May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing.

  2. As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement.

  3. May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary.

  4. Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients.

  5. Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.

  6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.

  7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.

  8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.

MINIMUM QUALIFICATIONS

High school diploma/GED or equivalent working knowledge.

Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience. Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently. Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences.

Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.

PREFERRED QUALIFICATIONS

Work experience with the Company’s systems and processes is preferred. Previous cash collections experience is preferred.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability.

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