TCHP Patient Financial Services Representative Associate - CBO Phys Div Billing - Full Time - Days

To provide support for all aspects of the Revenue Cycle credits and refunds process, Responsible for reviewing and reconciling overpayments for both insurance and patient payments.

Act in a manner that maintains confidentiality, protects and safeguards patient personal medical and financial information at all times.

Responsible for the timely and accurate resolution of insurance and self-pay overpayment issues, customer service and refunding/requesting recoupment of outstanding credit balances. Responsible for working with third party payors and intermediaries, following standard operating departmental procedures, to pursue prompt reconciliation of insurance and self-pay credit balances for assigned financial classes, while meeting benchmarks, performance measurements and reporting requirements.

Works collaboratively with internal/external stakeholders to resolve issues pertaining to assigned workgroup.

Interacts and works with other areas of the patient financial services team to identify and resolve issues related to the billing and collections of medical claims, as well as patient and insurance provider payment posting.

Performs other job-related duties and assignments as requested.

KNOWLEDGE AND SKILLS:

Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.

EDUCATION: High school diploma or equivalent required.

YEARS OF EXPERIENCE:

• 1-3 years (preferred) recent work experience interpreting payer contracts, professional and/or hospital reimbursement and billing compliance, developing and maintaining third party payer relationships, and familiarity with Patient Financial Services (PFS) processes for claim generation and submission, billing edits, payer processing requirements, and claim / medical records audit procedures

REQUIRED SKILLS AND KNOWLEDGE:

• Windows-based PC skills and computer proficiency required.

• Familiarity with medical terminology, ICD-10 and CPT/HCPCS coding systems preferred.

• Basic EMR/billing system knowledge required

• Basic claims clearinghouse system knowledge required

LICENSES & CERTIFICATIONS: