Patient Financial Representative

Department: 9255 - Crisis Care Center - Adult
Location: 601 N Frio
San Antonio, TX, 78207
Salary Range: $33,298.00 - $49,947.00 Per Year
Work Schedule: Monday - Friday 8:30 AM - 5:30 PM

PURPOSE

The Patient Financial Representative is responsible for supporting departmental efficiencies and clinic front office operations by performing all aspects of billing, collections and reimbursement duties for services rendered in a prompt and efficient manner. Their responsibility includes, but is not limited to, performing focused reviews (pre-audit) of scheduled and unscheduled patients’ records to determine financial eligibility, verification of insurance coverage and benefits, obtaining pre-authorizations and identifying patient financial responsibility. The Patient Financial Representative is responsible for ensuring state funded authorizations and patient funding sources are accurately entered in the Electronic Health Record (EHR). Additionally, they employ proper compliant patient liability collection techniques before, during & after date of service; counsel patients and families on insurance, payment issues, and account follow-up and payment resolution; and produce and monitor assigned reports. The Patient Financial Representative provides thorough, courteous and professional assistance to internal and external customers in accordance with the Center’s Behavioral Principles and Core Values.

TASKS 

  1. Conducts all phases of the Reimbursement Pre-Audit process 3-5 days prior to scheduled appointments and at time of unscheduled appointments. Notates any deficiencies on appointment sheet.
  2. Verifies In and Out Network insurance benefits for all patients that present for services.
  3. Verifies sessions and authorization dates. Requests insurance authorizations and/or extensions for services prior to service delivery and enter updates into EHR.
  4. Verifies and enters ANSA/CANS Rehab Authorizations. (Traditional Medicaid and General Revenue)
  5. Conducts CBO Screenings and Referrals.
  6. Communicates consumer MAP fees, account balances, co-pays or deductibles due prior to service delivery.
  7. Produces and manages weekly Reimbursement reports:
      • Suspense Report
      • GR Report
      • Private Pay Report
      • 3rd Party Denial Tickler Report
      • BECA Report, TMHP, Emdeon and IDX
      • Financial Review Report
  8. Ensures all Compliance errors are reported to the Business Office Administrator and maintains records and files of documentation supporting billing changes that are directed by Business Office Administrator.
  9. Responsible for working billing/reimbursement reports, providing proper documentation and making necessary corrections within specified times.
  10. Ensures quality standards are met and proper documentation regarding patient accounting records.
  11. Proactively reviews and resolves suspended services in accordance with procedure to prevent write-offs.
  12. Works correspondence and return mail.
  13. Collects co-pays, deductibles and other out of pocket amounts and fees at the time of visit as needed.
  14. Sets-up financial arrangements with patients as necessary.
  15. Reconciles daily collections and prepares deposits logs accordingly.
  16. Serves as backup to all Business Services Support functions.

 MINIMUM REQUIREMENTS 

  1. High School Diploma or GED
  2. Two to three (2-3) years’ experience with medical office clerical experience to include demonstrated customer service, scheduling, electronic health records and billing.
  3. Two (2) years’ experience and excellent working knowledge of insurance carriers' billing regulations and collection requirements by payors (i.e. Medicare, Medicaid, Private Insurance, and Maximum Monthly Fee (MMF).
  4. Experience calculating expected reimbursement according to payer regulations and/or contracts Demonstrated success working in a team environment focused on meeting organization goals and objectives required.
  5. Demonstrated success working in a team environment focused on meeting organization goals and objectives required.
  6. Proficiency with standard Microsoft Office applications and system databases, to include generating system reports and entering and retrieving data in EHR systems.
  7. Must maintain required credentials and mandatory training requirements to ensure compliance with all State regulations and CHCS policies.
  8. Must maintain a valid driver’s license and automobile insurance coverage, be able to travel as needed, and be able to meet on a consistent basis the driving record requirements of the Company’s auto insurance carrier if you drive your vehicle during company business.

  9. Must be able to meet the physical requirements to complete SAMA and CPR training including lifting up to 12 lbs. and supporting up to 55 lbs.; bending, stooping and getting on and off the floor without assistance.
  10. Must have adequate mobility that requires frequent walking, standing, bending, stooping, kneeling, reaching (vertical and horizontal), using fingers, hands, feet, legs and torso in various cares. The employee must be able to regularly lift and/or move up to 40 pounds and occasionally must lift and/or move up to 50 pounds. The employee must be able to occasionally transfer a consumer.

 

PREFERRED 

       1. Bilingual (English/Spanish) 

Physical Requirements/Demands = 2
1 = Primarily Direct Patient Care
2 = Primarily Office Work
3 = Primarily Physical Work

Compensation Package 

Salary Range: $33,298.00 – $49,947.00 Per Year

Recruiting and retaining talented individuals is important to us. At the Center for Health Care Services, we are committed to providing our employees with a total compensation package that includes competitive pay, affordable health and wellness benefits, generous paid time off, flexible work schedules, professional development opportunities and generous retirement savings options.

We have wide range of career opportunities and hope you will join us in our mission!

   Apply online today at: www.chcsbc.org 

 The Center for Health Care Services is an Equal Opportunity Employer