[Hiring] Patient Financial Services Associate II @Abbott

Role Description

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 ensures 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.

This position is remote.

Essential Duties

• Independently determine initial or ongoing patient insurance eligibility verification, investigate, and correct accounts within Epic.
• Interact with various insurances and third-party payors to ensure authorization is obtained and documented.
• Research missing or erroneous information on accounts using various portals and other resources.
• Review/edit claims and appeals prior to submitting to clearinghouse.
• Analyze, research, and resolve claim issues applying federal, state, and payor rules and procedures.
• Correct rejected claims from the claim’s scrubber, clearinghouse, or payor.
• Review explanations of payments, analyze, and complete appropriate steps for all denials.
• Investigate payor underpayments.
• Follow up with payors via phone on unpaid aging claims.
• Review denials and determine appropriate next actions.
• Provide any supporting documentation needed by insurance payor.
• Perform accurate and timely write-offs following identification of uncollectible accounts.
• Participate in regularly scheduled team meetings sharing denial trends.
• Provide ad-hoc support within the department as necessary.
• 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; adhere to all HIPAA guidelines/regulations.
• Exhibit excellent problem-solving abilities and organizational skills.
• Communicate effectively with all levels of staff through both verbal and written communications.
• Work in a team environment and adapt to changing workload and circumstances effectively.
• Conduct self in a professional manner in all interactions.
• 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.
• Complete an assessment showing understanding of Epic processes with a score of 80% or higher.

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.
• 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.

Compensation

The base pay for this position is $17.00 – $34.00/hour. In specific locations, the pay range may vary from the range posted.

Job Family

Accounts Payable & Receivables, Credit & Collection, & Payroll

Division

ONCO Cancer Diagnostics

Location

United States of America: Remote

Work Shift

Standard

Travel

No

Medical Surveillance

No

Significant 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).

Equal Opportunity Employer

Abbott is an Equal Opportunity Employer of Minorities/Women/Individuals with Disabilities/Protected Veterans.

EEO is the Law link - English: http://webstorage.abbott.com/common/External/EEO_English.pdf

EEO is the Law link - Espanol: http://webstorage.abbott.com/common/External/EEO_Spanish.pdf