This position coordinates the revenue cycle for the Luminis Health specialty hospital (e.g. Pathways, Conexus, J Kent McNew, etc.) billing, insurance and self-pay collection through recommendation for write off to outside collection agency. This position safeguards Luminis Health from losses by providing timely, constructive feedback on processes that may adversely impact reimbursement.
Essential Job Duties:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Implements and remains current on all regulatory and governmental agency requirements regarding billing and reimbursement.
- Ensures maximum cash flow by promptly and accurately billing claims related to their specialty.
- Minimizes financial losses by monitoring accounts receivable, collecting third-party payments and appealing the inappropriate denial of claims.
- Provides exceptional customer service to patients inquiring about their specialty bill and contacts patients and/or guarantors as appropriate.
- Acts as a liaison with patients, other departments and PFS teammates to obtain the information necessary to process claims and ensure payment.
- Identifies payer problems and initiates recommendations for solution to supervisor.
- Cross trains with other specialties, contributes to their success, and assists in the onboarding of staff for all areas of the Specialty A/R team
- Performs cash posting processes for accounts receivable including account proration.
- Facilitates refund requests as appropriate.
- Provides exceptional customer service to the departments which PFS supports.
- High School Diploma or GED, Associates Degree Preferred
- Two years of experience performing accounts receivable.
- Working knowledge of Excel and Word preferred
- Requires a minimum of CRCS certification
(non-certified applicants must agree to obtain certification within 12 months of hire)
Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.
Physical Demands -
Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.