Patient Financial Services Representative II

Full-time position (40 hours weekly), Monday through Friday dayshift.

As a key member of the revenue cycle team, you will complete assigned Patient Financial Services tasks including submission of electronic and manual insurance claims, resolving claim edits, insurance account follow-up, claim denial research, dispute and appeal submissions. You will act as a subject matter expert for coworkers, assisting in billing processes and problem resolution.

Responsibilities include reviewing and submitting hospital and physician claim forms (UB04, 1500) to insurance companies, handling special billing issues, resolving claim edits, following up with insurers for claim status and payment, submitting itemized bills and medical records, and reviewing remittance advice to ensure proper reimbursement. You will collaborate with department staff and external payers to resolve denials and provide trend analyses to leadership.

Additional duties involve coordinating with departments on precertification and authorization requirements, updating financial and demographic information, investigating account discrepancies, addressing payment variances, and assisting with onboarding and training new staff. You may lead projects and process improvement initiatives and serve as acting Team Lead as needed.

The role requires excellent communication skills, familiarity with ICD-10 and CPT codes, strong knowledge of payer policies, and proficiency in claims editing software and healthcare billing systems (Epic preferred). Medical terminology knowledge is important for claims and documentation interpretation.

Benefits include comprehensive health coverage, retirement savings plan, paid time off, education assistance, financial education and support including DailyPay, and expanded paid parental leave.

WellSpan Health is a mission-driven, integrated health system serving central Pennsylvania and northern Maryland, focused on comprehensive, equitable healthcare.