PFS代表 CBO 门诊账单跟进 Medicare
PFS Representative CBO Ambulatory Billing Follow-up Medicare
部门名称：
Amb Billing & Follow Up
工作班次：
白天
职位类别：
Revenue Cycle
创新且训练有素的员工。Banner Health最近获得了Great Place To Work®认证™。这一认可体现了我们对工作场所卓越的投入，以及对团队成员的工作满意度、幸福感、福祉和成就感的重视。了解我们如何不断改进，使Banner Health成为最佳工作场所和接受护理的地方。
PFS保险跟进代表（门诊拒付，Medicare团队）负责跟进指定的保险公司处理各种拒付情况，例如无授权、资格拒付等。该职位是一个更高级别的PFS角色，因为它涵盖所有患者群体和所有类型的提供者专业领域，以及从初始计费到零余额的完整索赔周期。具有医疗保险应收账款和医生按服务收费计费经验是理想的选择，熟悉Medicare、Medicare Advantage、Medicaid和商业保险者优先。
地点：远程
时间：周一至周五，8am-4pm AZ时间。培训后：成功完成培训计划后，轮班时间为6am-6pm，每天8小时。
理想候选人：
- 至少1年医疗保险应收账款（Medicare经验优先）和/或医生按服务收费计费（后端保险公司相关的索赔、拒付和上诉，简历中需明确体现）；
- 至少1年撰写保险公司拒付上诉信的经验；
- 中级到高级的Microsoft Excel技能。
只有居住在以下州的人员可以远程办公：AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV, WY
在Banner Health企业内，您将有机会运用您的独特经验和专业知识，支持全国知名的医疗领导者。我们提供广泛领域的富有挑战性和回报的职业机会。无论您的背景是人力资源、财务、信息技术、法律、管理护理项目还是公共关系，您都将找到许多为我们的获奖患者护理做出贡献的机会。职位概述
该职位协调并促进一个或多个指定计费区域的患者计费和收款活动，包括付款录入、收款、保险公司索赔研究和其他应收账款工作。作为团队的一员，确保准确及时地处理所有相关事务。
查看英文原文
Department Name:
Amb Billing & Follow UpWork Shift:
DayJob Category:
Revenue CycleInnovation and highly trained staff. Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care.
The PFS Insurance Follow-Up Representative (Ambulatory Denials, Medicare team) is responsible for following up with assigned payer for various denials, such as no authorization, eligibility denials, etc. This position is a higher-level PFS role, as it does range across all groups of patients and all types of provider specialties, as well as the full cycle of claim, from initial billing to zero balance. Experience with medical insurance AR and physician fee-for-service billing is ideal and knowledge of Medicare, Medicare Advantage, Medicaid, and Commercial insurance is highly preferred.
Location: Remote
Schedule: Monday-Friday, 8am-4pm AZ time. After training: varying 8hr shifts 6am-6pm after successful completion of training program.
Ideal Candidate:
- Minimum of 1 year experience in Medical Insurance AR (Medicare experience preferred) and/or Physician Fee for Service Billing (back-end payer-focused claims, denials and appeals (clearly reflected in uploaded resume);
- Minimum of 1 year experience writing appeal letters for payer denials;
- Intermediate to Advanced skill level in Microsoft Excel.
This can be a remote position if you live in the following state(s) only: AL, AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MD, MI, MN, MO, MS, NC, ND, NE, NH, NY, NM, NV, OH, OK, OR PA, SC, TN, TX, UT, VA, WA, WI, WV, WY
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.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.
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.
Additional related education and/or experience preferred.
Estimated Pay Range:
$18.02 - $27.03 / hourBanner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting.This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.EEO Statement:
EEO/Disabled/Veterans
Our organization supports a drug-free work environment.
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Originally posted on Himalayas