HCA, Hospital Corporation of America Patient Financial Services Representative in Iola, Kansas

  • Essential Functions: * (Detailed tasks, duties and responsibilities)

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    1. Reviews incoming mail daily for any denials, requests for records, etc. and processes appropriately.

    2. Resolves claim edits and works claim queues in Revenue Manager in a timely manner.

    3. Works to resolve issues in work queues in Revenue Cycle in a timely manner.

    4. Collaborates with Patient Financial Services Clerk as well as General Accounting in reviewing Remittance Advices for accuracy of posting.

    5. Performs Credit Balance analysis and processes refund requests as needed

    6. Completes insurance follow up on accounts when needed.

    7. Communicates with ancillary departments when assistance is needed to resolve charge or documentation issues in order to submit claims.

    8. Generates and sends letters or supporting documentation to payers as needed to validate timely filing.

    9. Researches and logs service requests to EHR vendor to resolve system issues.

  1. Answers patient questions and assists with accepting payments or setting up payment arrangements in a friendly manner, providing excellent customer service. May also assist patients with the financial assistance application and process.

  2. Enters appropriate comments on patient accounts in EHR.

  3. Attends continued education webinars and meetings.

  4. Attends other meetings as required or requested.

  • Rural Health Clinic Patient Financial Services Representative *

    1. Reviews incoming mail daily for any denials.

    2. Performs Credit Balance analysis and processes refund requests as needs.

    3. Completes insurance follow up on accounts when needed.

    4. Generates and sends patient statements monthly.

    5. Provides month end and year end reports to CFO in a timely manner.

    6. Posts payments to accounts in a timely and accurate manner.

    7. Assists patients with payment arrangements when needed.

    8. Identifies and submits accounts that need to be turned to bad debt.

    9. Performs troubleshooting and communicates with RHC EHR vendor.

  1. Completes insurance credentialing for all providers.

  2. Runs reports out of RHC EHR on demand as requested.

  3. Attends continued education webinars and meetings.

  4. Attends other meetings as required or requested.

  • Home Health/Hospice Patient Financial Services Representative *

    1. Submits/bills all third party payer services rendered

    2. Follows up on all claims and self-pay portions

    3. Reviews and process credit balances

    4. Reviews EOB and insurance remittance for accuracy of posting; works all billing vendor edits and rejected claims through third party electronic claims processor

    5. Completes coding with RN’s, compares coding on 485s and OASIS

    6. Applies for Medicaid PA’s and keeps track of renewals; works with clinical staff to determine what type of PA’s are needed.

    7. Send in prior authorization requests for Hospice nursing home patients who have Medicaid for room and board.

    8. Enter NOE’s for all Hospice patients with Medicare and/or Medicaid within a 5 day time frame.

    9. Review all OASIS assessments for accuracy and submit data within allotted time frame

  1. Check common working file to see if patients are eligible for Home Health or Hospice services

  2. Submits claims to Medicaid for Nursing Home Hospice patients and check requests for payments to the nursing homes

  3. Downloads Remittance Advices and transfer them to the file for Accounts Receivable; respond to insurance requests for documentation; track ADR’s through Ability Ease and follow-up with requested documentation as needed.

  4. Set up new payers in the Brightree system.

    • Minimum Requirements: * (Educational and job experience requirements. Knowledge, skills, abilities)

    Education: High School Diploma or equivalent required.

    Experience: Working knowledge of computer systems, personal computer experience, and ability to operate a 10 key calculator.

    Working knowledge of CPT and ICD 9 & 10 coding.

    One year of billing experience preferred.

Job: *Finance Acctg Billing Claims & Revenue

Title: Patient Financial Services Representative

Location: Kansas-Iola-SS- Allen County Hospital

Requisition ID: 8200-000697