[Hiring] PFS Representative CBO Billing Follow-up Denials Mgt @Banner Health

Role Description

Our PFS Representatives are a crucial part of revenue cycle involving reducing AR and improving patient experience firsthand, post-care. As a member of the PFS Rep CBO, Billing Follow-up Denials Mgt team, you will work with the Insurance companies on behalf of the patient to assist with obtaining payments for our Acute teams and/or Ambulatory teams. In this role, you’ll bring your experience with EOBs and medical claims experience to research and hold payers accountable to pay the expected rates according to the contracts in place with Banner Health, within the allowed timeframes.

Schedule: Full time, Monday-Friday, 8hr shifts, typically 8am-5pm (depending on team)

Location: REMOTE, Banner provides equipment

POSITION SUMMARY: This position coordinates and facilitates patient billing and collection activities in one or more assigned areas of billing, payment posting, collections, payor claims research, and other accounts receivable work. Works as a member of a team to ensure reimbursement for services in a timely and accurate manner.

CORE FUNCTIONS

• May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity.
• As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement.
• May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary.
• Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems.
• Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues.
• Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
• Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
• Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manager.

Qualifications

• 1 year patient financial services (Central Billing) or medical claims experience (clearly reflected in attached resume)
• Experience with submitting appeals and understanding of EOB
• General knowledge of codes used for claim processing

Requirements

• High school diploma/GED or equivalent working knowledge
• Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience
• Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently
• Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences
• Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required

Benefits

• Estimated Pay Range: $18.02 - $27.03 / hour
• Banner Health is committed to pay equity and transparency
• Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location

Company Description

Banner Health recently earned Great Place To Work® Certification™. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we’re constantly improving to make Banner Health the best place to work and receive care.

Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines.