Summary
The Patient Financial Specialist supports the Revenue Cycle division by ensuring timely and efficient account resolution and reconciliation of outstanding patient balances. This role works collaboratively across internal teams and external customers to support billing, collections, and vendor coordination activities.
Responsibilities
- Perform revenue cycle functions in alignment with CHRISTUS Health performance metrics.
- Support departmental quality and productivity standards.
- Collect and provide patient and payer information to support account resolution.
- Research government-mandated regulations and billing requirements prior to claims submission.
- Respond to account inquiries through written, verbal, and electronic communication.
- Maintain knowledge of insurance, self-pay billing, and third-party payer guidelines.
- Review claim edits, work rejected claims, and support resubmission activities.
- Correct RTP claims in the designated system per Medicare guidelines.
- Collect balances due from payors and identify underpayments and credit balances.
- Initiate Medicare redetermination, reopening, and reconsideration as needed.
- Coordinate with external vendors on account placement, transfers, reconciliation, and performance reporting.
- Audit vendor remittances and ensure fees and documentation align with contract requirements.
- Maintain accurate documentation in patient accounting systems and provide updates to leadership on trends impacting reimbursement and productivity.
Requirements & Qualifications
Qualifications
- High school diploma or equivalent required.
- Post-secondary education preferred.
- 1-3 years of experience preferred.
- Experience in a multi-facility hospital business office preferred.
- Experience with inpatient and outpatient billing forms such as UB-04 and HCFA 1500 preferred.
- Experience with Medicare and Medicaid billing processes and regulations preferred.
- Knowledge of Medicare language and the ability to reference CMS and Medicare regulations.
- Strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
- Strong written and verbal communication skills.
- No license or certification required.
Location
Irving, Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago