患者财务服务专员 II
Patient Financial Services Associate II
艾博生物是一家全球医疗健康领导者，致力于帮助人们在生命各个阶段活得更充实。我们的变革性技术产品组合涵盖整个医疗领域，在诊断、医疗设备、营养品和品牌仿制药业务方面均处于领先地位。我们的122,000名员工服务于超过160个国家的客户。
职位描述
职位概述：
患者财务服务专员（PFS）负责准确及时地处理索赔、申诉、拒付和账单。PFSAII 通过解决账单差异、资格认定、拒付、申诉以及逾期未付款索赔的跟进工作，展现其对医疗保险的知识，以实现最佳应收账款（AR）结果。PFSAII 向辅助部门传达保险信息，并通过 Epic、外部门户和其他软件确保适当的保险覆盖。审查并解决来自付款方的拒付、申诉和无回应的索赔，通过门户、致电付款方和系统调查确保准确的索赔解决。阅读并理解付款说明，以解决后端索赔问题。
该职位为远程办公。
主要职责包括但不限于以下内容：
- 独立确定患者初始或持续的保险资格验证，进行调查并纠正 Epic 中的账户；包括更新患者人口统计信息、财务信息和担保人信息。
- 能够准确及时地与各种保险公司和第三方付款方互动，以确保根据内部和外部政策和法规获得并记录授权。
- 使用各种门户和其他资源研究账户中缺失或错误的信息；包括联系和识别未知的付款方。
- 在提交至清算所之前审查和编辑索赔和申诉。
- 应用联邦、州和付款方规则和流程，独立分析、研究和解决索赔问题。
- 更正来自索赔检查器、清算所或付款方的被拒索赔。
- 审查付款说明，分析并完成所有拒付的适当步骤，包括正确识别索赔解决下一步措施；如申诉、核销或发送账单。
- 调查付款方的支付不足。
- 通过电话跟进逾期未付款的索赔。
- 审查
查看英文原文
Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries.JOB DESCRIPTION:
Job Description
Position Overview:
The Patient Financial Services Associate position (PFS) is responsible for the accurate and timely processing of claims, appeals, denials, and statements. A PFSAII demonstrates medical insurance knowledge by resolving billing discrepancies, eligibility, denials, appeals, and aged unpaid claim follow up for commercial, government, and plan coverage for optimal Account Receivable (AR) outcomes. PFSAII communicates insurance information to ancillary departments and ensuring appropriate coverage by utilizing Epic, external portals, and other software. Reviews and resolves payor denials, appeals, and claims with no response from the payors via portals, calls to payors, and system investigations to ensure accurate claim resolution. Reads and understands explanations of payments to resolve back end claim resolution.
This position is remote.
Essential Duties
include but are not limited to the following:
- Independently determine initial or ongoing patient insurance eligibility verification, investigate, and correct accounts within Epic; including updates to patient demographics, financial information, and guarantor information.
- Ability to interact with various insurances and third-party payors accurately and timely to ensure authorization is obtained and documented based on internal and external policies and regulations.
- Research missing or erroneous information on accounts using various portals and other resources; including outreach and identification of unknown payors.
- Review/edit claims and appeals prior to submitting to clearinghouse.
- Analyze, research, and resolve claim issues applying federal, state, and payor rules and procedures with a high degree of independence.
- Correct rejected claims from the claim’s scrubber, clearinghouse, or payor.
- Review explanations of payments, analyzes, and completes appropriate steps for all denials by appropriately identifying claim resolution next steps; including appealing, writing off, or sending statements.
- Investigate payor underpayments.
- Follow up with payors via phone on unpaid aging claims.
- Reviews denials and determines appropriate next actions; such as sending appeals or patient statements.
- Provide any supporting documentation needed by insurance payor.
- Perform accurate and timely write-offs following identification of uncollectible accounts adhering to policies and guidelines.
- Participate in regularly scheduled team meetings sharing denial trends specific to claim requirements to enhance front end claim edits to facilitate first pass resolution. Contribute ideas for workflows and best practices to maximize opportunities for performance, process, and net revenue collections improvement.
- Provide ad-hoc support, as necessary, within the department (i.e., special projects, provide support due to outages/high volume).
- Complete position responsibilities within the appropriate time frame while adhering to quality standards.
- Stay current with relevant medical billing regulations, rules, and guidelines.
- Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Excellent problem-solving abilities and organizational skills.
- Ability to communicate effectively with all levels of staff through both verbal and written communications.
- Ability to work in a team environment.
- Ability to adapt to changing workload and circumstances effectively; able to respond to new information quickly.
- Disciplined, self-motivated, and reliable.
- Ability to stay focused on a task and work independently; motivated to perform quality work.
- Diligent about arriving to work on time and completing tasks that are assigned in a timely manner.
- Conducts self in a professional manner in all interactions with members of the Clinical Laboratory team, clients, and associates.
- Possess a positive attitude.
- Work with others in a spirit of teamwork and cooperation.
- Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork.
- Support and comply with the company’s Quality Management System policies and
- procedures.
- Regular and reliable attendance.
- Ability to work normal schedule of Monday through Friday during normal business hours.
- Ability to work in front of a computer screen and/or perform typing for approximately 90% of a typical working day.
- Ability to work on a computer and phone simultaneously.
- Ability to use a telephone through a headset.
- You will be required to successfully complete an assessment showing understanding of
- Epic processes necessary to the job functions with a score of 80% or higher. Will make a reasonable accommodation available, if necessary, to assist an employee with a disability to satisfy this requirement.
Minimum Qualifications
- High School Diploma or General Education Degree (GED).
- 2 years of experience in medical billing, claims, and/or insurance processing.
- Extensive and current working knowledge of government, managed care, and commercial insurances claim submission requirements, reimbursement guidelines, and codes.
- Knowledge of medical terminology and/or health insurance terms.
- Knowledge of EHR operating systems and work involving electronic records.
- Proficient in computer systems and keyboarding skills.
- Demonstrated strong attention to detail and focus on quality output.
- Demonstrated ability to perform the Essential Duties of the position with or without accommodation.
- Authorization to work in the United States without sponsorship.
Preferred Qualifications
- Related Associate degree or medical billing certification.
- 4+ years of experience in medical or insurance billing field.
- Experience with Epic or other EHR application.
The base pay for this position is
$17.00 – $34.00/hourIn specific locations, the pay range may vary from the range posted.
JOB FAMILY:
Accounts Payable & Receivables, Credit & Collection, & PayrollDIVISION:
ONCO Cancer DiagnosticsLOCATION:
United States of America : RemoteADDITIONAL LOCATIONS:
WORK SHIFT:
StandardTRAVEL:
NoMEDICAL SURVEILLANCE:
NoSIGNIFICANT WORK ACTIVITIES:
Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hour day), Keyboard use (greater or equal to 50% of the workday)Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.EEO is the Law link - English: is the Law link - Espanol: Originally posted on Himalayas