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Banner Health currently has openings for Patient Financial Services Representatives.
The Patient Financial Services (PFS) department includes:
Commercial Insurance/Contracts Division
AHCCCS, Blue Cross, Tricare, VA, Work Comp and Audits Division
Medicare/Medicare Advantage Division
The PFS Department is responsible for the timely and accurate billing and collections of revenue based on CMS guidelines, payer contracts and federal regulations. We strive to create an environment that engages employees to produce at the highest level and recognition for their accomplishments. All individual and team work assignments are designed to collectively meet Banner's goals emphasizing excellent customer service and making a difference in our customer's lives.
PFS Rep Day to Day Responsibilities:
PFS Representatives are responsible for accurate billing of services rendered, timely and accurate collection of expected reimbursement. Once the payer has satisfied the expected reimbursement any patient responsibility balance is billed to the patient. These functions are accomplished by:
Review of Initial claims to ensure clean claim submission
Review and follow up on billed claims to investigate reason for payment delays or denials by contacting the payer or researching the payer website
Calling payers to verify receipt of claims, what is needed to resolve unpaid accounts, short paid claims and/or other complex denials
Take incoming calls from patients to assist with resolving their Commercial Insurance questions as well as self-pay balances
Clear documentation of all work activity in the Ms4 account to ensure continuity throughout the entire revenue cycle
Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
Please note: This is a requisition for various Patient Financial Services Representative positions that are open at the Banner Corporate Center - Mesa. During the application process, you will have the opportunity to apply to multiple positions attached to this requisition. Applicants will be considered accordingly.
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 1. 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. Coordinates with other staff members and physician office staff as necessary ensure correct processing.
2. 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.
3. 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.
4. 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. Provides assistance and excellent customer service to these internal clients.
5. Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.
6. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances.
7. Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
8. Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include all hospital patients, patient families and all third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
MINIMUM QUALIFICATIONS 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.
PREFERRED QUALIFICATIONS Work experience with the Company's systems and processes is preferred. Previous cash collections experience is preferred.
Additional related education and/or experience preferred.
Internal Number: R3232
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.