Senior PFS Accounts Receivables Representative

Banner Health

Full-time - Mid Level

Remote

Hospitals

About the position

The Senior PFS Accounts Receivables Representative plays a crucial role in the Acute Billing & Follow Up department at Banner Health. This position is designed for individuals who are not only skilled in patient financial services but also possess the ability to lead and mentor others. The representative will work closely with insurance companies to facilitate the payment process for hospital bills, particularly focusing on Medical Necessity claims. This involves a thorough understanding of the contracts in place with Banner Health and ensuring that payers are held accountable for timely payments. The role is integral in reducing accounts receivable (AR) and enhancing the patient experience post-care. In this position, the representative will be responsible for coordinating and facilitating patient billing and collection activities. This includes following patient accounts through the billing process, working with payors during claims processing, and ensuring that the facility receives appropriate reimbursement. The representative will also provide leadership to the patient financial services team, participating in the selection and training of new staff members. This role serves as a primary resource for complex and sensitive cases, demonstrating the ability to handle challenging situations with professionalism and expertise. The Senior PFS Accounts Receivables Representative will engage in various tasks such as processing payments, adjustments, claims, and correspondence in a timely manner. They will also be responsible for reconciling account balances, pursuing payments, and addressing denials. Building strong relationships with internal and external stakeholders is essential, as the representative will need to identify trends in payment issues and communicate effectively to resolve them. This position requires a proactive approach to reducing accounts receivable balances and achieving departmental goals. The representative will work independently under general supervision, utilizing critical thinking skills to solve problems and reconcile accounts efficiently.

Responsibilities

• Provide leadership and training to Patient Financial Services Representatives.
• Process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans accurately and timely.
• Reconcile, balance, and pursue account balances and payments, working with payor remits and facility contracts.
• Research payments, denials, and accounts to determine discrepancies and make necessary appeals and corrections.
• Build strong working relationships with assigned business units and hospital departments.
• Respond to incoming calls and make outbound calls to resolve billing and payment issues.
• Reduce Accounts Receivable balances as part of the patient financial services team.
• Use systems to provide statistical data and communicate with payors accurately.
• Work independently under general supervision, following defined standards and procedures.

Requirements

• High school diploma/GED or equivalent working knowledge.
• Two or more years of work experience in patient financial services, financial collecting services, or insurance industry processes.
• Knowledge of medical terminology and understanding of common insurance and payor types and authorization requirements.
• Ability to manage multiple tasks simultaneously with minimal supervision.
• Strong interpersonal, oral, and written communication skills.

Nice-to-haves

• Work experience with the Company's systems and processes.
• Previous cash collections experience.
• Related experience with financial institutions or background.
• Additional related education and/or experience.

Benefits

• Remote work options available in specified states.
• Opportunities for career growth within a nationally-recognized healthcare leader.