The third level of a career path in PFS . Responsible for all facets of patient accounting including the appropriate billing and follow up of patient insurance claims within filing limits and to support proper account completion and closure prior to 120 days post patient discharge or date of service. Works within a team based setting and ensures that workloads are distributed evenly. Responsible to perform the necessary account research required to determine proper governmental requirements prior to any claims submission. Supports the overall success of Patient Financial Services by demonstrating flexibility, collaboration and cooperation in a High Performance Work Team (HPWT) environment while, maintaining a high level of production and service quality. Supports multiple teams in the business office for the appropriate processing of all required work. Continues to gain knowledge and skills in an effort to further career growth path.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
High School graduate or GED.
3+ years in a related Healthcare Patient Accounting Field or 2+ years hospital, provider based, CAH or RHC billing experience.
Able to work in a high volume, fast paced work environment and perform and prioritize multiple tasks simultaneously.
Keyboard and data entry skills required. Computer experience is required with Microsoft Word and Excel, e-mail, and internet
communication, as well as the ability to work effectively with electronic work quality monitoring and electronic systems.
Requires the employee to have experience with or the capability to be trained to solve problems and work towards solutions in an independent and/or team manner.
Proven Proficiency in working all roles:
Hospital (Billing, Validation and Collections) within one payer type (Commercial, Medicare or Medicaid) and at least one additional role in another payer or cash posting or refund processing.
Professional (Billing, Validation and Collections) within one specialty and a minimum of two other functions either cash posting, refund processing, Billing, Validation or Collecting in another specialty.
Able to provide training and support for new team members.
For Customer Service: Proven proficiency in validation and collections for all payer types.
Hospital, Provider Based, Critical Access or Rural Health billing experience required.