Patient Financial Services Resume Samples

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Guide the recruiter to the conclusion that you are the best candidate for the patient financial services job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

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I Cruickshank

Isom

Cruickshank

59729 Runolfsson Spring

Dallas

+1 (555) 373 0257

59729 Runolfsson Spring

Dallas

Phone

p +1 (555) 373 0257

Experience Experience

Dallas, TX

Patient Financial Services Rep

Dallas, TX

Marquardt-Wehner

Dallas, TX

Patient Financial Services Rep

Schedules and pre-registers patients, correcting as necessary all patient demographic and
Resolves insurance claim rejections/denials and remedy expediently
Analyzes insurance coverage and benefits for service to ensure timely reimbursement
Promotes and maintains excellence in customer service
Monitors days in A/R and ensures that they are maintained at the levels expected by management. Analyzes work queues and other system reports and identifies denial/non-payment trends and reports them to the Billing Supervisor
Responds to incoming insurance/office calls with professionalism and helps to resolve callers? issues, retrieving critical information that impacts the resolution of current or potential future claims
Establishes relationships and maintains open communication with third party payor representatives in order to resolve claims issues

Detroit, MI

Patient Financial Services Supervisor

Detroit, MI

Jakubowski, D'Amore and Quigley

Detroit, MI

Patient Financial Services Supervisor

Creates environment of high associate satisfaction and retention, promotes diversity and creates a respectful work environment
Follows RevWorks policies, maintains a high level of confidentiality, upholds professional standards, and performs all work in a manner respectful of others
Leads staff to achieve established goals including performance metrics, productivity and service standards
Works in partnership with the Service Management Team to effectively and responsively support the Adventist Health client
Supports continual improvement towards industry top quartile performance related to key indicators of the revenue cycle
Assists PFS Manager with monitoring and gathering of data and completion of reporting
Flexibility to operate several systems platforms and balance tasks throughout the work day

present

New York, NY

Patient Financial Services Representative

New York, NY

D'Amore, Marks and Homenick

present

New York, NY

Patient Financial Services Representative

present

Responds to inquiries within a timely manner and provide proactive and regular updates to management on all areas of concern or improvement
Assist co-workers with problem solving
Daily management and resolution of patient rep system work list
Develop co-workers relationships and strive to become a “team player”
Actively participates in creating and implementing improvements
Attainment of performance proficiency in accordance with standards as specified in the Patient Account Representatives Situation Response Guidelines
Interview all patients courteously for financial discussion and accurate completion of financial paperwork

Education Education

Bachelor’s Degree in Business

Washington State University

Bachelor’s Degree in Business

Skills Skills

Excellent verbal and written skills as well as the ability to manage many details that may pertain to one issue
Strong accounting knowledge
Basic computer knowledge
Strong attention to detail
Ability to sit speak clearly and wear a telephone headset for 8 hours with occasional breaks
Ability to withstand occasional increased stress levels induced by agitated callers
Excellent communication skills
Good manual dexterity. strength and health of hands, fingers and wrists
Highly organized
Strong interpersonal skills

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15 Patient Financial Services resume templates

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Patient Financial Services Administrator Resume Examples & Samples

5+ year of direct Healthcare experience as Director of Patient Accounting/Registration Services functions
Bachelors Degree in Accounting, Business, Finance, and/or related field
Master's Degree in Healthcare and/or Business Administration

Patient Financial Services Manager Resume Examples & Samples

5+ years of hospital billing supervisory experience
Experience with Denials
Knowledge of Federal and State billing regulations
Comfortable handling a high volume of work
Proficient in computer platforms and applications
Prior experience with Siemens

Patient Financial Services Specialist Resume Examples & Samples

Customer service (internal/external)
Complete special projects with varied and complex components as needed
Previous experience working phones on an incoming and outgoing basis

Patient Financial Services Specialist Limited Term Resume Examples & Samples

Sources Patient Assistance program and/or foundation to assist patient’s in meeting out of pocket responsibility
Inbound and Outbound calls related to PAP, billing inquiries, collections and insurance verification
Documenting case files with complete notes on work
Mail Order Pharmacy experience

Patient Financial Services Representative Resume Examples & Samples

Patient accounting experience
Experience processing bills
Experience in financial services/billing/collections for a healthcare company
Self-motivated

Patient Financial Services Supervisor Resume Examples & Samples

3-5 years of experience in Patient Access, Customer Service, Insurance Verification, Billing and collections
Strong knowledge of ICD 9, ICD 10, and CPT codes
Demonstrated Customer Service excellence
Working knowledge of all Patient Access activities and their relationship to Revenue Cycle and Patient Financial Services
NAHAM or FHMA certification

Patient Financial Services Specialist Resume Examples & Samples

Sources Patient Assistance program and/or foundation to assist patients in meeting out of pocket responsibility
Inbound and Outbound calls related to Patient Assistant Program, billing inquiries, collections and insurance verification
Experience working in a pharmacy or insurance company
Must be able to work 11:30am – 8pm Monday – Thursday, Friday off, Saturday hours are based on the needs of the business

Patient Financial Services Resume Examples & Samples

Have a high school diploma or equivalent education
Have knowledge of patient financial services, or financial collecting services or insurance industry experience processes normally acquired over one or more years of work experience
Have the ability to manage multiple tasks simultaneously with minimal supervision and to work independently
Have strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences
Have strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required
Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately

Patient Financial Services Rep Ahcccs Resume Examples & Samples

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

Patient Financial Services Rep-main Admitting Resume Examples & Samples

Have knowledge of patient financial services, or financial service processes normally acquired over one or more years of work experience in hospital customer service and/or medical billing or related experience with a financial institution or background
Have strong organizational abilities
Be proficient in Professional Customer Service, oral and written communications, accurate and efficient keyboarding with strong competencies in the use of common office software applications
Have the ability to create spreadsheets to analyze and present data
Have effective teamwork skills
Have the ability to meet deadlines and productivity standards
Have previous cash collections experience (preferred)
As assigned, conducts patient visits for bedside registration to expedite the completion of the patient registration
Meets or exceeds productivity standards. Completes daily assignments and maintains accurate production logs and records. Identifies opportunities to improve work processes and practices good work group dynamics

Patient Financial Services Representative Resume Examples & Samples

Performs pre-registration/registration processes, verifies insurance coverage and obtains authorizations and notifications. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Obtains all necessary signatures and documentation requires by the patients insurance plan
Calculates patient liability according to verification of insurance benefits, collects deposits and co-payments
Provides financial counseling to patients and their families. Explains company financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patients and their families in completing financial assistance paperwork when appropriate
Acts as a liaison between the patient, the billing department and the payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence
Communicates with physicians, clinical and hospital staff, nursing and Health Information Management Services to resolve outstanding issues and/or patient concerns. Works to meet the patients needs in financial services

Senior Patient Financial Services Rep-admitting Resume Examples & Samples

Provides leadership and training to Patient Financial Services Representatives, and acts as a knowledge resource for internal customers. Serves as a primary resource in complex and/or sensitive cases. Oversees patient flow during the shift, assigning job duties to staff to ensure patient flow is maintained at an optimal level. Resolves employee/patient issues that arise during shift. Communicates employee issues to supervisor for follow up
Performs pre-registration/registration processes, verifies insurance coverage and obtains authorizations and notifications. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Obtains all necessary signatures and documentation requires by the patients insurance plan. May conduct patient visits for bedside registration to expedite the completion of the patient registration
Provides financial counseling to patients and their families. Explains Company financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patients and their families in completing financial assistance paperwork when appropriate
Communicates with physicians and other employees to resolve outstanding issues and/or patient concerns. Works to meet the patients needs in financial services
Acts as a liaison between patient/PFS department/payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence
Meets or exceeds productivity standards. Completes daily assignments and maintains accurate production logs. Audits the demographic and financial files created during shift for payor compliance and completeness. Identifies opportunities to improve work processes and practices good work group dynamics
Marginal functions may include transporting patients or conducting other work of the patient financial services team

Director of Patient Financial Services Resume Examples & Samples

Knowledge of hospital operations and patient flow so as to be able to identify, analyze and address potential sources of issues or patient dissatisfaction
Knowledge of accounting/finance principles that directly impact the account receivables, charge transfers, contractual allowances and adjustments, financial class changes and revenue reclassification, and reserve methodology and mechanics
Knowledge of third-party billing and collection processes, with particular focus on billing requirements, contractual arrangements, utilization guidelines, and certification/authorization processes, for both institutional and professional fees
Knowledge of quality management principles and techniques, process re-engineering, and change management
Knowledge of technology alternatives applicable to the patient financial environment, i.e. optical imaging, call center processing, collector workstation, etc
Knowledge of standard PC word processing, spreadsheet, and database applications
Excellent interpersonal skills in dealing with subordinates, colleagues, third-party vendors, patients and payer representatives
Exceptional analytical ability and organizational skills necessary to assess, prioritize, and organize information/tasks, and provide timely recommendations based on analytical assessment
Superb verbal and written communication skills to support interaction and participation in meetings with patients, physicians, payer representatives, and representation of other departments within Johns Hopkins
Proven leadership and management skills necessary to oversee multiple teams, recruit and mentor employees, and provide support to senior management
A minimum of ten years of experience within a large scale academic medical center, health system, or TPA industry
At least three years in a revenue cycle management capacity
At least five years of management experience
Prior work experience must include significant involvement in data gathering and analysis, process design and reengineering, quality improvement, and change management
Experience in using team building and quality management concepts to positively influence the work environment

Patient Financial Services Representative Resume Examples & Samples

Demonstrates experience in hospital and/or physician billing
Cash positing preferred
Critical thinking and problem-solving skills
Ability to communicate orally or in written format effectively
Good Interpersonal skills
10-key calculator
AS400 / iSeries
Outlook
Word Documents
Excel Spreadsheets
Internet

Director, Patient Financial Services Resume Examples & Samples

The ideal candidate will have 10+ years of progressive healthcare revenue cycle leadership and management experience with at least 3-years in a leadership role similar to scope and responsibilities of a Director of Operations position – primarily in a hospital setting
Experience should include a blend of strategic and operational experience with strong customer side exposure specifically in the Revenue Cycle Outsourcing industry
Demonstrable experience leading, coaching, and mentoring management and subordinates in a billing operations environment is required
Thorough understanding of all financial dimensions of P&L and healthcare revenue cycle management
Must be able to demonstrate superior organizational, management, leadership and problem-solving skills
1 or more years experience with McKesson Paragon and/or Relay Health software platforms
Knowledge of hospital billing systems and software required
Must be well organized, service oriented, energetic, and committed

Patient Financial Services Supervisor Resume Examples & Samples

Supervises Patient Financial Service Representatives in order to meet and maintain departmental metrics
Use independent judgment to research, troubleshoot, and identify billing trends and issues
Document and report daily metrics
Monitor calls for quality
Monitor individual performance metrics for quarterly/yearly review
Manage daily work flow within the department and adjusts schedules to meet business need
Demonstrate outstanding service orientation with clear verbal and written communications
Take escalated calls as required
Flexibility to operate several systems platforms and balance tasks throughout the work day
Fostering a customer service culture that strives for one call resolution and patient satisfaction
Contributes to the development of new procedures and processes and the modification of existing service procedures
Ensures that patient information remains confidential and that conditions for release of information be in accordance with compliance rules and regulations
Ensures Patient Financial Service Reps maintain compliant billing practices and adhere to the billing algorithm
May perform other duties as assigned by Director
3+ yrs Medical Billing/Coding experience preferred
2+ yrs Supervisory/Management required
2+ yrs Customer Service experience preferred
Proficiency in Excel required
Laboratory experience preferred

Patient Financial Services Systems Manager Resume Examples & Samples

Three (3) years experience and excellent working knowledge of Patient Financial Services analytical operations in a healthcare environment
Three (3) years in a management position (preferably in a hospital environment)
Strong understanding of various hospital systems including ADT, patient accounting, electronic billing and payment posting, and document imaging
Knowledge of healthcare industry regulations, managed care contracting, and end to end revenue cycle exposure
High energy candidate who will lead his / her team in accurate reporting, resulting in decrease in AR Days, decrease in Denials, and motivate his/her team to meet all other revenue cycle metrics
Ability to create and implement continuous process improvement practices to continually refine Business Office practices
Strong analytical, written, oral communication skills including interpersonal communication and problem solving
Advanced Skills with MS Access
Knowledge of databases maintenance and extensive report writing
Bachelor’s degree in Business Systems or Administration
Experience managing non - exempt union employees
Experience working with SQL and other report tools
Demonstrated success with building and guiding a team to develop and monitor collection processes to meet organization goals and objectives. Experience with providing visible sponsorship and guidance of major change initiatives
Experience and knowledge of Patient Accounting Systems and applicable supporting systems for billing, collection, post-payment review, financial reporting, reimbursement and payment processing in a multi-facility environment
Strong knowledge of Medicare and Medi - Cal regulatory and compliance requirements

VP, Patient Financial Services Resume Examples & Samples

Provides financial leadership support and guidance to executive and hospital leadership. Proactively seeks alignment between finance and operation leadership teams
Partner with the Hospital Chief Financial Officers and other corporate strategic leaders to build a vision and strategies to assure quality integrated services that meet or exceed organizational needs. Clearly communicate the business model and tactics to stakeholders
Develops and is responsible for the achievement of annual and periodic goals for significant statistical indicators of revenue cycle performance and for the organization’s overall revenue and cash collection performance
Develops, implements, and manages efficient and effective operational policies, processes and best practices within the functions of the revenue cycle. This includes but is not necessarily limited to: scheduling, admission/intake processes, authorization/pre-authorization of services, insurance verification, charge capture, claims processes, payment posting, credit balance management, billing practices, vendor and A/R management
Maximizes the collection of payments and reimbursements from clients, patients, residents, Medicare, Medicaid, private payers, guarantors, etc. Maintains a working knowledge of insurance carriers, payers, and processes utilized within the revenue cycle
Ensure an adequate balance between legal and financial responsibility to ensure compliance with external laws and regulations
Possesses extensive knowledge of revenue cycle and regulatory requirements associated with governmental and commercial payers and billing. Serves as the subject-matter expert on regulatory, compliance and legal requirements associated with medical billing and CMS. Ensures compliance with relevant regulations, standards and directives from regulatory agencies and third-party payers
Leads the development and implementation of revenue strategies to maximize profitability. Works closely with the Executive Management team on the development and implementation of client-friendly coding, billing and reimbursement guidelines
Assesses and responds to internal and external healthcare trends in order to establish and ensure the necessary direction for revenue cycle activities. Continually seeks ways and means for improving the delivery and support of revenue cycle activities and programs, whether through technology, outsourcing to vendors or internal processes
Understanding of the inter-departmental related functions of a complex healthcare organization. Extensive understanding of all revenue cycle functions and dependencies
Hands-on experience and knowledge of healthcare billing and cash collections, process improvement, A/R management, payer relations and systems development/implementation. Extensive knowledge of healthcare billing systems is a requirement
Expert level analytical and data analysis skills, with a proven ability to develop and analyze complex issues
Strategic thinking with a high regard for execution on company objectives and initiatives. Proven capabilities in building an organization and directing teams. Ability to work with others in a cooperative, collaborative manner
Strong written/oral communication and presentation preparation/delivery skills
Experience starting new department and/or bringing decentralized department practices into centralized practice

Patient Financial Services Specialist Resume Examples & Samples

Sources Patient Assistance program and/or foundation to assist patients in meeting Out Of Pocket responsibility
Inbound and Outbound calls related to Patient Assistant Program, billing inquiries, and insurance verification
1 to 2 years of customer service experience
Comprehensive knowledge of Microsoft Products including Word, Excel and Outlook
Intermediate to High level of Windows Based system navigation
Must be able to work a shift between 8:00am and 8:00pm EST Monday through Friday and Saturdays from 8:00am to 6:00pm EST (Fridays off if you work Saturdays)
Strong communication and telephonic skills (including soft skills and de-escalation)
At least 1 year of effective communication through
Previous Healthcare and/or Mail Order Pharmacy experience

Patient Financial Services Specialist Resume Examples & Samples

Source Patient Assistance program and/or foundation to assist patients in meeting Out Of Pocket responsibility
Take inbound and make outbound calls related to Patient Assistant Program, billing inquiries, and insurance verification
Provide customer service (internal/external)
Must be able to work a shift between 8am and 8pm EST Monday-Friday and Saturdays between 8am to 6pm (Fridays off if you work Saturdays)

Director of Patient Financial Services Dept Resume Examples & Samples

Develops and maintains controls within Patient Financial Services (PFS). Manage and develop a high functioning patient billing and collection team that includes manager and supervisor levels that support delegation and oversight. Direct and manage accounts receivable (A/R) to ensure accounts are collected appropriately. Continually assess and develop an organizational structure that supports high performance results. Work in partnership with labor to ensure that the contract in place is monitored and followed. Will require regular meetings, addressing of grievances, job placement issues and possibly negotiations. Identify performance indicators and benchmarks to drive improvement. Develop and maintain departmental policies and procedures to support efficient operations. Develop staff who can analyze and recommend ongoing improvements to processes, procedures, systems. Directs the timely processing of charge and cash posting payments
Maintain and follow guidelines of the Sarbanes Oxley requirements; ensure that required audits are completed on a timely basis, and issues identified are researched and addressed on an ongoing basis. Ensure departmental understanding and commitment to compliance with external and internal legal and regulatory billing and collection requirements, in particular, Medicare and other governmental agencies
Set annual goals and objectives that support high performance. Motivate staff, support KP values, and insure performance reviews are routinely performed. Responsible for developing regional training strategy, including budget, focus, and process to ensure billing staff is properly trained resulting in compliance with billing guidelines and accuracy / completeness of bills
Collaborates with health plan administration, medical and dental operations to provide support in the pursuit and attainment of organizational goals, including setting priorities for strategically focused areas, identifying opportunities for improvement and advising on specific areas of expertise. Serves as liaison to Accounting, Financial and Operations and other related departments to support integrated and coordinated financial operations, including reporting for senior health plan and physician leadership
Minimum eight (8) years of progressive hospital patient accounting experience
Minimum three (3) years of managing a large patient accounting department
Master's degree in business, finance or accounting
Prior management of a union-represented staff
Professional billing in a hospital/clinic setting
Certification from HFMA or other related organization

Manager, Patient Financial Services Resume Examples & Samples

Manage PFS supervisors (specific teams as designated by PFS director), coordinate training and establish, approve and maintain the Policy and Procedures for the department. Ensures staff organization to promote efficiency, accountability and appropriate segregation of duties. Establish and maintain quality and production standards for the department. Establish and follow already established KPI and dashboard to achieve and sustain PFS operational goal. Keep Dir. Updated of the department dashboards, HR issues and escalated matters requiring intervention
Write and implement PFS policies to support compliant billing, collection, accurate accounting, and timely follow up to ensure appropriate reimbursement. Ensure timely payment posting and charge entry. Maintain provider enrolment processes. Develop tools to provide appropriate information to General Accounting and revenue-producing departments, including feedback to service providers. Monitor and maintain dashboard, established baselines, assist in design clear desk procedure to align all operations on policies
Leads continuous improvement, identifies and investigates system vulnerabilities which may impact adversely compliance and or member experience. Strives to eliminate variation in the process outcome
Represents PFS at cross-departmental meetings regarding operations, strategy, and compliance. Works closely with various business partners to ensure collaborative, productive working relationships between departments
In consultation with stakeholders, develops internal controls for the PFS department controls. Serves as PFS liaison with the Human Resource department to make sure all personnel issues are dealt with in a timely manner and according to KPNW policies. Represents the PFS department in labor bargaining negotiations with SEIU, Local 49
Oversees and advises Department Director on the management of the consolidated PFS department budgets, monitors FTE levels, and coordinates staffing needs across sub-departments among total FTE's available. Forecasts budget performance, update on department performance standings and needs
Minimum seven (7) years of prior experience working in a medical business setting, such as medical billing requirements, EFT transactions, 835/837 processes, claims edit concepts, or medical banking solutions
Minimum five (5) years experience in a management capacity
Prior experience as a manager in business environment
Prior experience in a hospital or large group practice reimbursement department in a management capacity
Experience in EPIC healthcare information systems, particularly billing or payment posting module
Knowledge of medical office, hospital and/or Hospice operations
Complete knowledge of insurance products
ICD-9/10, CPT knowledge
Knowledge of large billing practice and hospital billing computer systems

Patient Financial Services Representative Resume Examples & Samples

Maintain Emergency Room logs (written and computerized)
Develop co-workers relationships and strive to become a “team player”
Adhere to written hospital policy and procedure
Maintain professional, business-like appearance

Supervisor Patient Financial Services Resume Examples & Samples

Attends meetings and trainings, participates in committees and work groups to assist with quality and work performance issues
Provides patient education regarding financial approval process for services rendered
Meets with patients and their families to discuss potential out-of-pocket expenses related to services rendered and assists in location of resources or assistance programs for which uninsured or under insured patients may be eligible. Set up payment plans for current balances and future anticipated balances
Coordinates communication of pre-certification and approval process with department clinics and University hospitals, patients and families in order to coordinate comprehensive patient account services. Advises department billing staff regarding insurance benefit and financial clearance status of patients

Patient Financial Services Rep-varied Schedule Resume Examples & Samples

A High school diploma/GED or equivalent education
At least one year of work experience/knowledge of patient financial services, or financial collecting services or insurance industry processes
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
Communicates with physicians, clinical and hospital staff, nursing and Health Information Management Services to resolve outstanding issues and/or patient concerns. Work to meet the patients needs in financial services

Patient Financial Services Rep-admitting Resume Examples & Samples

High School Diploma, GED, or equivalent education-required
Knowledge of patient financial services, or financial service processes-required
1 or more yrs of work experience in hospital customer service and/or medical billing or related experience with a financial institution or background-required
Financial counseling education &/or experience-preferred

Patient Financial Services Supervisor Resume Examples & Samples

Schedules and supervises the work of assigned staff to achieve the defined business goals and to ensure smooth work flow in the department. Coordinates team activities and the staff-to-workload ratios to accomplish the most effective use of resources. Sets work goals for team members and monitors measurable outcomes in accuracy, timeliness, productivity and service quality
Provides leadership, work goals and coaching for staff. Selects, hires and trains staff for assigned area. Manages labor expenditures within budgetary guidelines. Conducts performance reviews, counseling/disciplinary action and termination of assigned staff. Works with the team to achieve designated work goals
Uses advanced business and software skills for creating documents, letters, spreadsheets, reports, graphics, and presentations

Patient Financial Services Rep-pre Reg & Admitting Ccmc Resume Examples & Samples

High school diploma/GED or equivalent working knowledge
Knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience
Work experience with Banner's systems and processes, preferred
Previous cash collections experience, preferred
Bilingual English/Spanish, highly preferred
Energy
Excitement
** Come join a ROCK STAR TEAM! ****
Consistently meets monthly individual productivity goal as determined by management. Completes daily assignments/work lists, keeps electronic productivity log up to date and inputs information accurately. Identifies opportunities to improve process and practices good teamwork

Collections Clerk, Patient Financial Services Resume Examples & Samples

Minimum of 3 years billing and/or collections experience in a medical group, healthcare company/insurance, or hospital industry
Experience with medical billing and/or collections terminology (i.e. CPT, HCPCS, and ICD-10 coding)
Experience with various insurance plans offered by both government and commercial insurances (PPO, HMO, EPO, POS, Medicare, Medicaid, HRAs, etc) and coordination of healthcare benefits, including requirements for referral, authorization and pre-determination
Experience with reading and understanding the information provided on EOBs, remittance advices, and other insurance correspondence, and in calculating patient responsibility taking into consideration coverage and benefits, including referral, authorization, and/or pre-determination requirements, and contract terms
Experience with reviewing and analyzing insurance payments, and/or payor adjudication of claims against contract terms and patient coverage and benefits
Excellent customer service skills with ability to interact with both internal and external customers, i.e. patients, insurance payors, doctors, internal departments and handle in a professional manner with customer-friendly focus and attention to detail in resolving issues
Experience with HIPAA guidelines and healthcare compliance
Experience with MS Office suite (Word, Excel, Outlook), and internet and web site navigation
Ability to maintain composure, and to follow instructions and protocols when dealing with unfamiliar or unusual payor / customer issues
Demonstrated ability to present information in a clear, concise, and grammatically correct manner both verbally and in writing
Demonstrated collaboration skills (including active listening skills, presentation skills) and proven ability to work effectively in a diverse, inclusive organization and environment
Demonstrated ability to accept and carry out oral and written instructions accurately
Demonstrated ability to prioritize work, handling daily and multiple tasks to completion within the time allotted, while working as part of a team within a demanding environment
Ability to prepare forms, spreadsheets, and graphs
Experience in a payor or medical provider community that deal with all aspects of the revenue cycle
Experience in a large corporate (even matrixed) environment
Internal candidates, minimum 4 months of experience working in Medtronic PFS department
Previous work experience with GE Centricity
Ability to sit, wear a headset, and work on the computer for extended periods of time
Ability to sit/stand/walk 8 hours per day
Ability to occasionally lift up to 10 lbs

Senior Director, Patient Financial Services Resume Examples & Samples

Works with leadership to establish baseline and target metrics for key processes to ensure that benchmarks are met
Uses analytics to identify benchmarks that are outside of targeted measures, investigates the reasons and recommends remediation strategies
Oversees development, implementation and maintenance of workflows as well as policies and procedures to ensure accurate, timely and compliant third party collection activity
Responsible for responding to audit requests from regulatory bodies and third party payers
Manages the monthly close and reconciliation of the billing system and provides A/R summary updates at monthly close meetings. Collaborates with other members of the Finance Department to ensure that all month-end and year-end reporting is submitted timely and accurately for financial statement preparation and third party reimbursement reporting
Works with other members of the Finance Department to ensure proper valuation of patient receivable, including appropriate reserve requirements for third-party allowances and bad debts
Works with external audit firm with respect to patient accounting matters, including gathering records, explaining transactions, reviewing processes and addressing other relevant audit issues
Oversees outpatient charge description master and charge capture functions to maximize revenue opportunities in a compliant manner
Oversees coding functions to ensure consistent use of federal and local industry standards and ensure compliant coding practices
Oversees all facility third party payer enrollment applications and requirements
Provides subject matter expertise via participation in forums, committees as well as managed care contracting and payer settlement discussions
Develops short and long term goals and objectives, consistent with those of the Institute as well as the Finance Department
Develops action plans to implement goals and evaluates outcomes on a quarterly basis. Assists managers in development of specific goals and action plans. Reviews goals on a monthly basis and implements corrective action plans as needed
Develops cross-team communications, solutions and recommendations to identify, address and resolve business and system issues
Oversees numerous projects and applications, such as outsourced receivable vendor management, system updates and business development initiatives
Develops, recommends, implements and administers a budget which provides for the attainment of agreed-upon goals and objectives for the areas of responsibility; manages within pre-determined limits to ensure operational efficiencies and obtain pre-determined performance targets
Maintains professional expertise through involvement in professional organizations and continuing education programs
Manages and develops a results oriented team, including senior manager, manager and supervisor levels. Continuously assesses and develops an organizational structure that ensures high performance and achievement of goals
Encourages team members to adhere to professional standards and to expand competencies
Hires, trains, evaluates, disciplines and discharges, as needed, managerial and supervisory personnel. Reviews the recommendations of managers and supervisors regarding employee matters and provides guidance to resolve complex or sensitive employee issues
Bachelor’s degree required, MBA or equivalent preferred
Eight to ten years as an experienced departmental leader with a track record of creating and maintaining a “best practice” revenue cycle department with demonstrated patient accounting experience within a complex academic, healthcare organization
Broad experience interacting with people across all levels of management and staff
Proficient in MS Office Suite, including Outlook, Excel, Access and Word
Epic experience preferred
Exceptional communication and leaderships skills, with the ability to motivate staff and increase productivity
Strong ability to manage multiple high priority initiatives and bring them to completion in a timely manner
Strong technology skills, with emphasis on automating systems and processes
Highly refined analytical skills are necessary along with a strong sense of task prioritization
Ability to work across multifunctional areas as well as manage varying priorities
Highly motivated, energetic, collaborative and decisive
Strong problem solving and trouble shooting skills
High standards and strong customer service orientation

Patient Financial Services Resume Examples & Samples

One to two years’ experience in a customer service setting, preferably in a Healthcare facility
SMS and Soarian experience preferred
Demonstrated skills in oral and written communication

Patient Financial Services Collections Manager Resume Examples & Samples

Manages the work of Patient Financial Services collection team members by empowering, coaching, answering questions, giving guidance, and leading by example
Ensures compliance with state and federal laws regulations for Government and Non-government and other third party payers. Thorough understanding of revenue cycle concepts including HMO, PPO, POS, EPO and capitation
Maintains ongoing knowledge of UB-04, HFCA 1500, ICD-9 and ICD-10 and other mandatory state billing forms and filing requirements
Facilitates the identification of issues and solutions by team members
Ensures compliance of customer expectations and requirements
Provides feedback to the other Managers, Director of PFS and Facility Managers, regarding the accurate identification of payers and registration of patients
Monitors billing, collection, post payment review and correspondence and processes to determine improvement opportunities
Provides team members with opportunities for learning, creativity, and personal growth
Generates enthusiasm and commitment among team members; fosters and reinforces team-based results
Evaluates individual and team performance, identifies areas for improvement, and makes recommendations to team members and business leaders
Conducts formal performance reviews and provides feedback to team members. Works with team members to improve, track, and develop areas of poor performance
Monitors performance of Patient Financial Services collection team and ensures key performance indicator criteria are met or exceeded
Monitors and manages performance relative to standards set by the Service Level Agreements (SLA) with customers
3 -5+ years experience providing leadership and management direction related to billing and collection processes within a multi-facility environment
3- 5+ years experience and excellent working knowledge of patient financial services operations
Excellent experience in customer service processes including correspondence
Experience and knowledge of Patient Accounting Systems and collection reimbursement applications in a multi-facility environment
Demonstrated success with building and guiding a team to develop and monitor billing and collection processes to meet organization goals and objectives
Experience as a Patient Accounts Manager
Experience in patient and payer relation processes including correspondence and payer inquiry methodologies
Experience with providing visible sponsorship and guidance of major change initiatives

Patient Financial Services Representative Resume Examples & Samples

Answer incoming calls from patients in need of assistance with their account
Assist patients with understanding the claims process and Alere’s billing policies
Assist patients with understanding patient responsibility
Process/Reprocess claims
Submit adjustments
Complete notation of account in Alere’s billing system
Accept and process patient payments
Accept and set up patient payment arrangements
Must be able to provide outstanding customer service
Must have exceptional phone etiquette
Knowledge of Microsoft Office (Excel, Word, Outlook)
Knowledge and experience with the medical claims process
Ability to read and understand Explanation of Benefits
Skill in answering calls and communicating via email in a professional, pleasant and helpful manner
Ability to establish and maintain effective working relationships with internal and external clients
Must be well organized and detail-oriented
Ability to operate a computer and office equipment
Thrive in fast paced environment

Director, Patient Financial Services Resume Examples & Samples

Bachelor's Degree in Business or related field required
Five (5) years of acute care hospital or health system billing/collection experience
For Profit experience required

Patient Financial Services Manager Resume Examples & Samples

Ability to handle multiple assignments and prioritize tasks effectively
Excellent verbal, presentation and written communication skills
Ability to deliver results in a dynamic and fast-paced environment
Ability to contribute individually and collaborate in a team as necessary
Proficiency in Microsoft applications, especially Excel
Ability to work overtime and irregular hours as necessary
Strong relationship building, teamwork and flexibility
Ability to proactively define and execute process improvement
Ability to work with all levels of the organization
Ability to work with sensitive information and maintain confidentiality
Minimum 5 years of managing in healthcare specific to Accounts Receivable
Must reside in or be willing to relocate to Kansas City, MO
CRCR certification

Coo-patient Financial Services Resume Examples & Samples

Assist VP and CFO in implementation of the SSC’s future direction and supporting operational initiatives
Implements policies, programs and actions plans to ensure successful development of managers and team members
Accountable for translating SSC service standards and policies into expectations for direct and indirect reports
Ensures appropriate systems and processes functioning appropriately to provide safe, efficient and customer-focused services to internal and external customers
Accountable for meeting productivity and quality standards for processes and production for assigned departments and functions
Ensures compliance with all applicable federal, state and corporate regulations, policies, and rules within areas of accountability
Responsible for adherence to established budget for assigned areas of accountability and explanation of any variances
Accountable for monitoring and achievement of assigned performance targets for areas of responsibility
Evaluate new initiatives and best practices to elevate performance in assigned areas
Promote teamwork and a professional environment via helping co-workers when needed while portraying a positive attitude
Assist with resolving patient, physician and interdepartmental complaints and misunderstandings
Performs other duties as directed by the VP

Dirirector, Patient Financial Services Resume Examples & Samples

Leadership – guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services
Tactical Execution – oversees the development, deployment and direction of complex programs and processes
Policies & Procedures – articulates

Director, Patient Financial Services Resume Examples & Samples

New acquisitions – perform due diligence, and perform duties related to cutover to CHS ownership. Accounting for straddle log patients between new and old ownership interests. Notification to payers of the change of ownership. Coordination of old AR – whether purchased, outsourced, or in the case where the AR was not purchased, then working with the seller’s representative going forward. Coordination of training hospital personnel on CHS policy and procedures, as well as our revenue cycle and vendors; example, CHS14 acquired hospitals or other stand alone facilities. Oversight of all revenue cycle processes until / unless assigned to an RCSC, especially until attaining same store status
Divestitures – coordinate aspects of revenue cycle from CHS to new ownership, including cutover, and oversight of CHS accounts receivable if it’s not sold
Computer system conversions – participating in host system and ancillary system conversions. Current state vs future state assessments, and identification/resolution of any resulting gap analysis. Participating in the training of staff on new systems, but in particular on operational changes and policy/procedure impact or questions
Charge capture / revenue integrity - work with hospital departments and revenue integrity team on charging issues, charge reconciliation, etc
Assisting the RCSC’s - folding or unfolding facilities from an RCSC, or assistance when folding one RCSC into another. When folded in, assistance in determining best resource to remain as the onsite manager / patient access director. Assistance transitioning that person into their new role. Serving as a liaison back to the facility, or Division mgmt
Cash Flows – Identify and provide oversight to all cash inflows/outflows for divestitures and acquisitions. Work with Finance, Third Party and Cash management teams in determining cut/off and transition of funds including patient AR, Third Party and other associated cash. Ensure cash processes in place with consideration for balancing and recognition
Other lines of business / consolidated results - assist CFO/administrative team, RCSC, and/or Corp Revenue Cycle with issues and/or consolidated key indicator results regarding other lines of business such as nursing homes, home health, joint ventures, clinics, etc
Vendors - assist CFO/administrative team, RCSC, and/or Corp Revenue Cycle with onsite vendors, such as non-CHS SP conversion vendors, acquisition hospital vendors, denial vendors, Bank of America, etc. Assist ESS, particularly with new / problem hospitals, and serve as a liaison to hospitals / Divisions as needed. Transition of terminated vendors, and inventory. Perform quarterly audits of the various vendors
Compliance – provide additional attention to Internal Audit or Compliance dept findings. Assistance in development of related action plans, and follow up training / sampling. During site visits identify / rectify potential compliance issues. Reinstallation of corporate processes where they’ve become dismantled, perhaps because of non-compliance, or turnover
Work with Finance for potential income statement impact for problem receivables across the system
Special projects as assigned to include assimilation of revenue cycle reporting as directed by VP
Denials – site support for resolution of denial vendor issues, development / implementation of denial action plans, and work with hospital staff including other departments
Standardization – through training, and site visits make sure standard policies and procedures are followed, as well as convey best practices, especially as practices overlap across RCSC assignments, Divisions, and/or stand alone or acquisitions and the RCSC’s

Patient Financial Services EDI Analyst Resume Examples & Samples

Monitors daily translation and transmission of electronic billing claims and printing of UB92, UB04, HCFA 1500 and CMS 1500 claim forms, including identifying and correcting errors, and ensuring balancing of all activities by extracting crucial data elements and performing analysis on results
Obtains and prepares and posts daily, weekly and monthly payment and adjustment transactions using the electronic posting program. Identifies errors and exceptions, researches, corrects and posts to appropriate accounts with adequate documentation. Ensures all transactions balance and identify and correct errors
Researches and evaluates third party claims companys' edits and modifications with payer units to validate appropriateness for Banner Health billing processes. Validates compatibility of new or requested edits with existing billing processes and procedures
Researches, implements and tests new lines of electronic billing and posting. Participates in new software setup requiring engagement of other Banner departments, vendor contacts, and internal reviewers
Utilizes multiple systems and/or programs to provide statistical data in support of issues list(s) provided to payers and internal customers/management
Maintains an accurate and low balance in claims billing system and General Ledger holding accounts for irreconcilable transactions. This entails contacting possible recipients, researching payment documentation, reviewing patient accounting system, contacting finance department, reviewing GL transactions, and participating as needed in bank account reconciliations
May provide training to other staff, provide feedback to improve processes, and work on special projects. May function as a project/or process lead within the unit

Senior Patient Financial Services Representative Resume Examples & Samples

Testing, validation and implementation of Cerner Ambulatory
As assigned, researches payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary
Responds to incoming calls and makes outbound calls as required to resolve billing and payment issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers
Uses systems to provide statistical data, prepare issues list(s) and to communicate with payors accurately

Patient Financial Services Rep Senior Resume Examples & Samples

Significantly higher inpatient survival rates
Higher 30-day survival and lower readmission rates for acute myocardial infarction, heart failure, and coronary artery bypass grafting patients
$1,200 to $6,000 less in total costs per patient case

Director Patient Financial Services Resume Examples & Samples

Customer Orientation – establishes and maintains long term customer relationships, building trust and respect by consistently meeting and exceeding expectations
PC Skills – demonstrates proficiency in Microsoft Office applications and others as required
Financial management – applies tools and processes to successfully manage budget

Senior Patient Financial Services Representative Resume Examples & Samples

Customer Service oriented
Exceptional phone etiquette
Previous Billing experience

Director Patient Financial Services Resume Examples & Samples

Organization - proactively prioritizes needs and effectively manages resources Communication - communicates clearly and concisely
PC Skills – demonstrates proficiency in Microsoft Office applications and others as required Financial management – applies tools and processes to successfully manage budget
Patient Access or Hospital Business Office experience Minimum 5 years management experience

Patient Financial Services Resume Examples & Samples

Selects, trains, coaches, motivates, conducts performance evaluations, and directs the workflow for the Patient Financial Services staff. Develops goals and performance expectations for staff. Establishes work procedures and directs the daily work of staff. Ensures timely and accurate patient registrations by monitoring and developing the subordinate staff to provide the highest level of service and performance
Provides information on patient registration and scheduling to all concerned departments. Maintains ongoing positive communications with patients, staff, physicians and other third parties to provide information or resolve issues
Maximizes cash flow by maintaining and monitoring the protocols and activities associated with the financial management of the patient account, including up-front cash collections
Develops, maintains and adheres to the annual departmental budget. Prepares departmental schedule to ensure appropriate staffing levels at all times while remaining within budget guidelines
Provides effective leadership and coaching to enable registration team members to meet designated quality and productivity goals. Ensures maximum employee and departmental performance by conducting ongoing analysis of department and employee productivity, using available statistical standards and providing appropriate training and developmental opportunities
Proactively engages in process improvement. Identifies needs, updates and improves work processes and methods. Provides opportunities for strategic departmental improvements and communicates suggestions appropriately

Quality Auditor, Patient Financial Services Resume Examples & Samples

Act as a liaison between PFS and all its Vendors. Responsible for Vendor AR and all their performances. Research and perform timely follow-up on accounts/files/invoices by conducting routine reconciliation processes. Investigate and correlate information from multiple sources. Coordinate all issues with Vendor. Able to read and understand all reports received from Vendor. Verify and research discrepancies and data received from Vendor and prepare financial reports for PFS and General Accounting department to that end. Be available to the Vendor leadership for questions regarding KPNW transfers and invoices. Represent Kaiser PFS in cross-departmental meetings when appropriate. Attend and assist with leading all Vendor meetings. Work closely with various business partners to ensure collaborative, productive working relationships
Conduct audits of claims, bill statements, adjustments, refunds, credits, ePremis and etc. for timelines, appropriateness and quality. Validate that all data elements are accurate in accordance with the SOX and Non-SOX control being addressed to ensure that the PFS dept. complies with the SOX and Non-SOX requirements and/or conforms to regulatory guidelines and internal controls. Perform monthly Quality audits in coordination with the PFS Supervisors. Process and resolve CIDARS requests in an appropriate, effective and timely manner
Analyze results and identify patterns, trends and variations in billing practices and make recommendations for improvement. Recommend workaround processes to meet immediate business needs while working with management to develop long term solutions. Meet with leadership to develop policies and controls to support accurate and timely billing. Provide consultation to other departments on billing clarity and relevance of billing to ensure the efficiency and productivity of the billing process. Maintain positive relationships with internal/external business partners and staff
Contribute to the development and maintenance of billing education materials. Create written procedural documentation for SOX and Non-SOX controls to assist in training and compliance. Create and maintain tools to effectively perform audit functions. Provide education and/or training, when needed, if patterns of errors are identified, changes in billing or billing policy occur, or when proactive measures are needed
Maintain adept and accurate knowledge of Patient FinancialServices SOX and Non-SOX controls. Maintain current billing knowledge and skills
Minimum four (4) years of prior insurance billing experience in a revenue cycle related position
Minimum three (3) years of general office experience with a complex on-line system
Minimum one (1) year of experience in medical terminology
Extensive computer and telephone experience
Minimum six (6) years of billing/collections experience in a Kaiser Permanente revenue cycle related position
Minimum one (1) year of auditing experience in a complex healthcare system
Minimum three (3) years of advanced experience with Microsoft Office, including Access, Excel, Word and PowerPoint
Minimum three (3) years of experience in medical terminology and coding guidelines
Minimum one (1) year experience working with Vendors in a Healthcare environment
Bachelor's degree in business administration, finance, health administration or other related field
Knowledge of Kaiser Permanente Health Plan coverage and benefits
Knowledge of Kaiser Permanente computer systems and applications
Knowledge of Kaiser Permanente organization policies and procedures
Knowledge of CMS on-line guidelines
Knowledge of Kaiser Permanente Accounts Receivable systems
Ability to quickly analyze and develop solutions to complex issues
Knowledge of billing requirements, coverage and benefits for private health insurers, federal and state agencies, CMS Medicaid and Medicare
Knowledge of Fair Debt Collection Practice Act for Federal, State, and Regional laws
Knowledge of State, Federal, and CMS agencies
Knowledge of government and non-government EOB reconciliation
Knowledge and application of medical terminology, Revenue codes and/or CPT-4, HCPCS and ICD-9CM (10) coding

Patient Financial Services Director Float Resume Examples & Samples

Communication - communicates clearly and concisely
Patient Access or Hospital Business Office experience
Minimum 5 years' management experience

Patient Financial Services Representative Resume Examples & Samples

Identifies problem accounts with payors; investigates and corrects errors, follows-up on missing account information, and resolves past-due accounts. Uses knowledge and collection techniques to provide accelerated accounts receivable recovery and effectively collect or resolve patient accounts
Reviews accounts for submission to third party payors and receivables; initiates transfers, cancellations, audit adjustments and verification of charges to patient accounts; and reviews all accounts as assigned
Contacts patients including answering inquiries by telephone, mail, or regular mail and informs them of outstanding balances on their accounts and arranges for payment of balances owed while maintaining a positive customer service approach. Advises patients of financial options available within the community. Negotiates and establishes payment plans
Researches and responds to patient and payor questions pertaining to either an individual invoice or account utilizing Cerner, Meditech, Fortis & NEBO systems, to obtain the information necessary to answer questions
Follows HIPPA guidelines documents and maintains records in patient accounting files requiring on-line functions in the Patient Accounting and Registration systems including updating patient demographic information and initiation of account adjustments
Duties involve the use of information systems, Cerner and Meditech, computer terminals, and a variety of software and/or conventional office equipment
Responds to inquiries within a timely manner and provide proactive and regular updates to management on all areas of concern or improvement
Associates Degree in Business Administration, or related field or in lieu of degree, two years of proven Customer Relations experience in an insurance or health care organization required
Two years of experience in a similar job in an insurance or healthcare organization required
Exceptional human relations/customer service skills and a high degree of diplomacy and tact necessary. Must have the ability to deal with a variety of people under stressful circumstances. Must be able to work as a member of a team
Strong analytical and organizational skills
Excellent verbal and written skills as well as the ability to manage many details that may pertain to one issue
Previous experience with Meditech or Cerner/Profit systems preferred

Patient Accounts Spec Patient Financial Services Days Resume Examples & Samples

Serve as a liaison for the patient in resolving their questions and concerns
Maintain a high quality of work, and be receptive to any suggestions on improvements based on periodic audits
Maintaining a team-oriented mindset
Prioritize effectively and manage assigned work queues to resolution with timely follow-up
Participate in continual training and education events
Participate in Patient Financial Services department events
Experience with Government and Managed Care products claim processing
Ability to interpret Government payment policies including LCDs and NCDs

Manager, Patient Financial Services Resume Examples & Samples

Bachelor’s degree from an accredited college/university is preferred, preferably in Business Administration
Must have a minimum of 5 years of recent experience and understanding of hospital Medicare billing/collections and commercial billing processes
Minimum 2 years supervisory experience in hospital Medicare billing/collections and commercial billing
Experience with hospital patient accounting systems, preferred
Ability to interpret an extensive variety of concepts such billing/collection regulations and requirements
Knowledge of medical terminology, ICD9 and CPT procedure coding
Ability to effectively and appropriately communicate ensuring exceptional customer service
Computer experience – Microsoft Word and Excel proficient
Ability to perform multiple tasks, strong verbal and written skills and sound decision-making abilities
Knowledge of HIPAA compliance requirements

Patient Financial Services Resume Examples & Samples

Provide excellent customer service to customers and external business partners (MedData and National Collections Agencies) using various forms and means of communication to appropriately respond to questions and inquiries
A. Provide customers and external business partners with accurate information and account status. This requires thorough review of GPMS/NextGen and MedData Portal; review of account Notes; review of EOB’s and/or any other correspondence received and accurate assessment of new and/or revised information provided
B. Request and validate the account information necessary for billing and claim submission.This may include primary and secondary insurance information, patient’s legal name, billing guarantor, current address and telephone number
C. Make every effort to fully resolve issues at time of the inquiry. Escalation of accounts is appropriate only when Associate is unable to resolve issues. Refer to department guidelines for required actions
D. Handle client complaints in a professional manner following all policies and procedures. In the event a patient/parent disputes the billed amount or validity of services, attempt a resolution; but if caller remains dissatisfied, advise of the right to file a formal, written billing dispute in accordance with policy/procedure
F. Verify 3 separate elements of the patient account including the patient’s date of birth, prior to speaking with clients
G. Elevate problems or trends to the department’s Management
C. Using MasterDatabase, correctly select a payer code that represents the subscriber’s insurance and financial class
A. Take appropriate actions to resolve various categories of MedData Info Requests found in the Web Portal within 72 hours. These include account research, notating web Portal and GPMS/NextGen, insurance verification and account updates
B. Work pre-submission exclusion reports on a daily basis (a.k.a. scrubbing reports) to resolve any discrepancies prior to placement with MedData
C. Work daily Exception Reports generated from MedData OutSource Programs. These can be found in Printer Management
D. Perform analysis and work accounts generated from the 150 Day Reconciliation Report in order to reconcile GPMS/NextGen and MedData
E. Work Front End Reconciliation Reports to ensure daily file transmissions are successful and prevent inconsistencies between both billing systems
F. Work various MedData Queue maintenance Reports to include but limited to CPRESUM and Not Worked

Patient Financial Services Manager Resume Examples & Samples

Management of the business office staff and related functions, including admitting, billing and collections for a large acute behavioral healthcare facility
Appropriately utilizing a combination of staff and external resources in a manner which will most effectively achieve hospital financial objectives
Developing and maintaining a thorough, current knowledge of healthcare billing and collections procedures
Will discharge responsibilities in a manner which will enable the hospital to achieve and maintain integrity and compliance with known payer requirements and those services are reflected accurately in a thorough manner in all business/office related reports, claims, billings and statements
Providing leadership to ensure that the business office staff is properly trained and directed to maintain compliance in all aspects of the hospital's business office operations and services
Responsibilities require focus on mutually agreed upon objectives and corporate defined policies and procedures to ensure that business office operations are implemented according to policy

Patient Financial Services Analyst Resume Examples & Samples

BA in Business, or related field or an equivalent level of education/training
A minimum of three (3) years experience in hospital billing, coding and denials management
Demonstrated ability to retrieve, report and analyze financial data
Proficient computer skills in Excel, MS Word, Access, etc
One year of experience in a healthcare setting involving interaction with PFS Department and ancillary departments
Competent in systems utilization (Health Logic, OnBase, DSG, MediTract, EPIC, Excel, MS Word, and other applications as appropriate)

Patient Financial Services Analyst Resume Examples & Samples

A minimum of two (2) years analysis or operations experience; or equivalent combo of education and experience
Competent in systems utilization; Health Logic, OnBase, DSG, MediTract, EPIC, Excel, MS Word, and other applications as appropriate
MBA Project Management experience

Patient Financial Services Rep Cbo-surgery Center Resume Examples & Samples

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
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 companys collection/self-pay policies to ensure maximum reimbursement
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

Supervisor Patient Financial Services Resume Examples & Samples

Supervise and assist day to day claims operations tasks in accordance with established policies and procedures, standard operating procedures, and job aids to ensure optimal performance results
Responsible for supervising the efficient, professional and timely processing of all claims, claims related questions, and appeals
Supervise claims inventory/workflow through claim life cycle. Monitor contractual compliance and claims processing turnaround times to ensure compliance with all regulatory agencies
Prepare reporting using established departmental reporting tools to include, but not limited to, timeliness, claim inventory, outstanding pends and staff productivity
Educate team to ensure timely and accurate claims processing. Develop and maintain training and reference materials that support and are consistent with Company, health plan and regulatory agencies. Establish training protocols and conduct skill verification process
Track problems and/or issues from identification to resolution. Provide ongoing updates to all stakeholders with regards to status of issue
Work with team to identify incomplete or questionable claims. Target opportunities to identify and resolve these systematically
Take responsibility for positively influencing the morale of the staff, including motivation and recognition of employees who consistently achieve outstanding results. Foster teamwork by involving examiners and processors in design/implementation of solutions to problems or new business
Handle customer escalations and ensure appropriate follow-up with customers. Keep key stakeholders informed. Provide direct feedback and training to staff based on outcomes if appropriate
Develop and maintain understanding of all software involved in the claim payment process. Work with I&T staff to implement changes as needed
Supervises the PA Government, Commercial, NCMC, and WC Unit ensuring compliance with health plan standards and contractual requirements. Responsible for maintaining established DuPage Medical Group Coding and Reimbursement guidelines. Support Customer Service Department as needed
Organization: Able to provide order and structure to daily processes and work environment. Demonstrates good organizational skills and ability to prioritize daily work
Verbal Communication: Capable of interacting with, and relating to, people of varying educational levels and backgrounds, conveying information clearly and succinctly, applying listening, tact, responsiveness, empathy, and confidentiality. Effective in communicating verbally with other staff and departments
Adaptability: Able to work well with frequent interruptions and shifting priorities, multi-task and work across functional lines to accomplish goals
Problem Sensitivity: Effective in identifying and analyzing problems
Attention to Detail
Team Work: Must be able to get along with others, work as part of a team, accept constructive criticism, adapt behaviors quickly, and consistently follow and apply work rules. Works effectively with others to accomplish objectives and goals. Willingly offers assistance to others when the need arises. Fosters teamwork and positive rapport within all departments to maximize achievement of goals
2-4 years medical claims (professional and institutional) processing/adjudication/UR/Managed Care/Prior Authorization experience, including 1-2 years as a Lead or Supervisor
Able to build strong working relationships with cross functional team and among members of the organization at different levels
Strong team building and leadership skills; able to mentor, motivate and inspire others
Uses sound business judgment; demonstrates ability to analyze and resolve problems using sound business judgment
Be able to identify trends, make recommendations, and implement effective action plans to address improvement opportunities
Working knowledge and understanding of the medical insurance industry and health plans
Minimum of 3 to 5 years of previous coding and billing experience
Experience in multi-specialty physician coding is highly preferred

Manager of Patient Financial Services Resume Examples & Samples

Manages daily operations to assure accuracy, timely completion of assigned tasks, and achievement of area specific revenue cycle goals within budgeted expense guidelines. (25%)
Diagnoses and solves issues impacting departmental objectives. Works collaboratively with other PFS and WPAHS departments, external agencies, vendors, and payers to achieve results by utilizing specialized revenue cycle expertise and communicating effectively in both written and verbal formats with staff, peers, all levels of management, and all encounters. (25%)
Practices effective staff management in order to achieve desired departmental outcomes for operating results, employee job satisfaction, staff productivity, and leadership development. Supervises staff in a fair and consistent manner, evaluates work, and recommends and implements approved corrective actions. (25%)
Fulfills the role as a dynamic leader within WPAHS and PFS to promote and support the achievement of overall organizational goals and specific revenue cycle objectives. (25%)
BA/BS Degree or equivalent education and experience required
Completes duties and assignments with a high degree of independence; seeks guidance regarding issues outside the scope of policies / procedures / operational standards
Forges effective working relationships with all constituents
Works effectively under pressure; supervises several projects and initiatives concurrently; proactively identifies issues and effectively problem solves; addresses and/or removes barriers for subordinates; responsible for the quality and timeliness of deliverables
Responsible for recruiting, retaining, developing and evaluating staff and establishing subordinates' performance goals in conjunction with the Director
Requires strong management, leadership, delegation, and interpersonal skills
Proven ability to function independently and to develop, implement and formally document plans of action
Outstanding analytical, problem solving, and presentation skills preferred
Minimum 5 years healthcare experience related to revenue and billing cycle strongly preferred

Patient Accounts Specialist Patient Financial Services Days Resume Examples & Samples

Treat patients, families, co-workers, physicians and guests with kindness, care, and courtesy
Communicate to leadership potential process improvements
Adhere to all policies that govern the PFS department
Keep a positive attitude in the department and with current workflow
Pursue knowledge regarding AR management, especially from co-workers and management
Understand the Patient Financial Services process guides and give feedback to team leads on improvements
Work to achieve department goals
Act in a manner that is consistent with the Shawnee Mission Health mission and values
Evaluation of variances between expected and actual reimbursement

Patient Financial Services Specialist Resume Examples & Samples

Knowledge of UB, CMS 1500, ADA and other utilized billing forms Data Elements and payor requirements
Knowledge of Epic Hospital Billing Accounts Receivable (A/R) Transaction Codes and basic accounting principles
Knowledge of Epic Hospital Billing system, internal filing systems, medical centers registration systems and third party databases
Knowledge of PFS and medical centers compliance and ethics policies and procedures
Knowledge of office machines and equipment
Epic, commercial payor, follow-up and denial experience
Experience with Regence follow-ups and denials

Manager, Patient Financial Services Resume Examples & Samples

Minimum of two (2) years’ experience working with Medicare and Medicaid insurance as well as commercial insurance plans and benefits (PPO, HMO, POS, EPO, and Indemnity) required
Current driver’s license in state of residence and insurable driving record required
Minimum of two (2) years’ experience in a healthcare organization working with clinical staff and patients preferred
Intermediate computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required
Successful management experience required

Manager, Patient Financial Services Resume Examples & Samples

Manages colleagues to established standards for quality and quantity
Completes performance evaluations and performance improvement plans for work unit colleagues
Creates and updates work unit procedures so that work is accomplished accurately and efficiently
With guidance from HR and Director and within HR policy, the manager is to fairly manage human resource issues such as hiring and progressive discipline
As required by Director, provides meaningful reporting on progress towards goals, work unit issues, productivity, quality indicators, work throughput, adjustments to changes, compliance with applicable regulation and health plan requirements, use of technology, employee issues and planning efforts
The manager works with colleagues and managers from other work units and departments to improve performance, problem solve and plan
Manages expenses to budget
Demonstrates an understanding of the job description, performance expectations, and competency assessment
Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards
Performs all other duties as needed or directed to meet the needs of the department Qualifications Minimum Qualifications

Patient Financial Services Rep Resume Examples & Samples

Monitors days in A/R and ensures that they are maintained at the levels expected by management. Analyzes work queues and other system reports and identifies denial/non-payment trends and reports them to the Billing Supervisor
Responds to incoming insurance/office calls with professionalism and helps to resolve callers? issues, retrieving critical information that impacts the resolution of current or potential future claims
Establishes relationships and maintains open communication with third party payor representatives in order to resolve claims issues
Reviews claim forms for the accuracy of procedures, diagnoses, demographic and insurance information, as well as all other fields on the CMS 1500
Reviews and corrects all claims/charge denials and edits that are communicated via Epic, Explanation of Benefits (EOB), direct correspondence from the insurance carrier or others and uses information learned to educate PFS and office staff to reduce future denials and edits of the same nature. Initiates claim rebilling or corrections and obtains and submits information necessary to ensure account resolution/payment
Identifies invalid account information (i.e.: coverage, demographics, etc.) and resolves issues
Evaluates delinquent third party accounts and processes based on established protocols for review, payment plan or write-off
Reviews/updates all accounts for write-offs and refunds
Completes all payment posting assignments per the turnaround standards. Reports unfinished assignments to the Billing Supervisor
Keeps informed of all federal, state, and managed care contract regulations, maintains working knowledge of billing mechanics in order to properly ascertain patients? portion due
Completes all assignments per the turnaround standards. Reports unfinished assignments to the Billing Supervisor
Handles incoming department mail as assigned
Attends meetings and serves on committees as requested
Maintains appropriate audit results or achieves exemplary audit results. Meet productivity standards or consistently exceeds productivity standards
Provides and promotes ideas geared toward process improvements within the Central Billing Office
Assists the Billing Supervisor with the resolution of complex claims issues, denials and appeals
Completes projects and research as assigned
Enhances professional growth and development through in-service meetings, education programs, conferences, etc
Complies with policies and procedures as they relate to the job. Ensures confidentiality of patient, budget, legal and company matters
Exercises care in the operation and use of equipment and reference materials. Performs routine cleaning and preventive maintenance to ensure continued functioning of equipment. Maintains work area in a clean and organized manner
Refers complex or sensitive issues to the attention of the Billing Supervisor to ensure corrective measures are taken in a timely fashion
Observes irregularities in the cash/denial posting process and reports them immediately to the Billing Supervisor
Accepts and learns new tasks as required and demonstrates a willingness to work where needed
Assists other staff as required in the completion of daily tasks or special projects to support the department?s efficiency
Performs similar or related duties as assigned or directed

Patient Financial Services Rep Resume Examples & Samples

1) Responding to and processes patient and responsible party telephone calls and correspondence regarding questions and issues related to Lahey charges, billing statements, health plan coverage, health plan denials, coordination of benefits and other questions in regards to the Lahey revenue cycle
2) Makes outgoing telephone calls and sends correspondence to patients and responsible parties on outstanding accounts receivable, payment plans, health plan coverage, denials and coordination of benefits
3) Evaluates and resolves patient complaints consistent with Lahey policy and procedure
4) Coordinates resolution of issues with Customer Relationship Management, Clinical Department, Coding and Medical Records, Patient Financial Services and other Lahey colleagues
5) Confirms Lahey charges, diagnoses, patient eligibility, demographics, health plan coverage, coinsurance, coordination of benefits and claim denials to satisfy patient questions and complaints
6) Assists patients with applications and supporting documents for financial assistance eligibility
7) Requests and follows up on documentation/coding reviews performed by certified coders and providers for claims with coding and medical necessity issues
8) Determines and processes account adjustment transactions in accordance with department procedures. Completes transactions using the appropriate adjustment code(s) allowing for account level and reporting integrity
9) Utilizes computer generated work files and reports to clear statement edits, identify accounts for bad debt
10) Reviews credit balances for appropriate transactions including approval for refunds
11) Records auditable documentation on individual account activity including correspondence, telephone contacts, fax, email and other communications
12) Identifies and works with unit members and management to resolve coding, billing, denial, reimbursement trends and other revenue cycle problems identified
13) Maintains and reports productivity statistics as required
14) Maintains strict adherence to the Lahey Clinic Confidentiality policy
15) Incorporates Lahey Clinic Guiding Principles , Mission Statement and Goals into daily activities
16) Complies with all Lahey Clinic Policies
17) Complies with behavioral expectations of the department and Lahey Clinic
18) Maintains courteous and effective interactions with colleagues and patients
19) Demonstrates an understanding of the job description, performance expectations, and competency assessment
20) Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards
21) Participates in departmental and/or interdepartmental quality improvement activities
22) Participates in and successfully completes Mandatory Education
23) Performs all other duties as needed or directed to meet the needs of the department. Qualifications Minimum Qualifications
General understanding and knowledge of the Center for Medicare and Medicaid Systems (CMS) billing and coding requirements and compliance expectations
Excellent customer service knowledge and skill
Working knowledge of Government and commercial health plan insurer coverage, claim requirements and remittance processing
Working knowledge of health care coding systems (Procedural, Diagnosis, Modifier, Remittance and others)
Understanding and ability to utilize various electronic, web based and manual coding resources
Ability performing transactions in a patient accounting system
Proficient data entry computer skills
Demonstrated ability to utilize word processing, spreadsheets and work files in performing work tasks
Demonstrated attention to detail and accuracy
Skillful ability to use calculators to reconcile amounts
Stong communication skills including verbal in person, telephone and written
Demonstrated ability in being a cooperative and productive member of team
Ability to troubleshoot problems
Ability to continue to learn skills and expand knowledge

Patient Financial Services Systems Analyst Resume Examples & Samples

Associates Degree, or in lieu of degree,10 years of Systems Analyst experience
Proven understanding of medical business office operations as it pertains to third party billing and physician reimbursement activities
Experience with hospital claims
Solid understanding of information systems and an intermediate level of knowledge of Microsoft Word, Excel and Outlook applications
An ability to analyze and resolve complex issues
Effective verbal and written communications skills, and strong presentation skills (including the ability to present concepts in user-friendly language)
An aptitude for learning new skills and concepts quickly and completely
Project management and systems testing experience
Meditech systems experience

Patient Financial Services Specialist Resume Examples & Samples

Associate’s Degree in Accounting, or equivalent experience
Demonstrated experience analyzing Accounts Receivable accounts
Working knowledge of PMHS
Prior accounting or related finance experience

Patient Financial Services Supervisor Resume Examples & Samples

Ensures compliance with the Joint Commission, federal, state, and other regulatory agencies related to PFS
Assists PFS Manager with monitoring and gathering of data and completion of reporting
Manages performance of staff assigned to PFS work and ensures appropriate staffing mix and levels are met
Leads staff to achieve established goals including performance metrics, productivity and service standards
Identifies process and system performance improvement opportunities in PFS and implements improvements to billing systems and collection techniques within the confines of federal and state collection laws
Supports continual improvement towards industry top quartile performance related to key indicators of the revenue cycle
Ensures customers and families receive the highest quality service in a caring and compassionate atmosphere which recognizes the individuals’ needs and rights
Audits staff monthly to ensure best practices are followed
Coordinates activities and schedules work assignments to meet deadlines
Leads and represents client’s mission and values and ensures adherence by all PFS associates
Creates environment of high associate satisfaction and retention, promotes diversity and creates a respectful work environment
Works in partnership with the Service Management Team to effectively and responsively support the Adventist Health client
At least 2 years of relevant revenue cycle experience
Associate's degree in Accounting or a business-related field or equivalent work experience
Management/Supervisory experience
Experience with Patient Financial Services extensive billing, account follow up and collection
Hands-on knowledge of Third Party Payer, Managed Care, Workers Compensation and other Government and Non-Government billing regulation
Must be located in or near the Hanford, California area or be willing to relocate
Proficient computer skills, including Microsoft Office Suite

Patient Financial Services Hrs Resume Examples & Samples

Working knowledge or Healthcare billing and collections
Excellent interpersonal skills required to communicate with different groups of employees and agencies
Must possess strong time management skills. Work efficiently and organizes time appropriately. Must have the ability to prioritize daily work assignments
High level of analytical ability in order to and interpret information from various sources
Working knowledge of Windows based software (including word processing, database and spreadsheet)
Ability to learn and utilize the Hospital Information systems Revenue cycle module

Patient Financial Services Director Resume Examples & Samples

Manage the team responsible to develop best practices, identify root causes and structure prompt resolutions to denied claims
Responsible for the education of the department(s) on revenue cycle standards
Accountable for the performance of all assigned locations to meet standard revenue cycle performance metrics that align with MGMA and/or other defined SLAs/measurements
Own the relationship between Cerner RevWorks and all Ambulatory Denials Leadership
Own and execute processes through appropriate system applications
Educate associates on policies, procedures, and plans
Contributes to the development and maintenance of processes, policies, and work flow documentation
Troubleshoots issues, works toward resolution and understands when to escalate issues
Researches information and performs reporting
Works in accordance with corporate, organizational compliance and security policies and procedures
Proactively identifies process improvements and system enhancements
Engages in special projects
Troubleshoots system issues or process failure points, identifies root cause and collaborates with other groups to resolve
Owns high profile projects, complex issue resolution, and increased scope of work
Demonstrates knowledge of the team's core processes and functions
Creates an environment with high associate satisfaction including promoting diversity and creating a respectful work environment
Manages a majority of situations independently, escalates appropriately on complex situations
Is able to execute on planning without assistance
At least 7 years of relevant revenue cycle experience
At least 5 years of management experience, managing a minimum of 20 employees
Prior experience successfully managing multiple physician practices simultaneously
Experience establishing and achieving ambulatory revenue cycle performance indicators
Must be located in or near Hanford Area, California and/or willing to relocate
Must be willing to travel occasionally as needed
Effectively copes with change and adjust priorities accordingly
Proven expertise in communicating with a broad stakeholder community
Demonstrates computer skills including being proficient using Microsoft Excel
Communicates effectively and determines appropriate communication mediums (e.g. phone, face-to-face, email, etc.)

Manager Patient Financial Services Resume Examples & Samples

Bachelor Degree in Business Administration, Finance, Accounting, Healthcare Administration or related field or equivalent training and/or experience required
Experience in Hospital Government payer (Medicare and Medicaid) billing leadership will be considered
Healthcare Financial Management Association (HFMA) Patient Accounts and Hospital Accounting Certification preferred
CPAR certification, Advanced CPAR or CPAM preferred. * Significant (5+ years’ experience) with the following: Direct management within a PFS department overseeing 10+ FTEs, with particular emphasis on follow-up; Hands-on knowledge of Medicare, Medicaid and Medicaid CMO billing regulations
Experience with UB04 and HCFA 1500 claim forms, both manual and electronic submissions
Hands-on knowledge of CPT, ICD-9, HCPCS, and Revenue codes, as well as hospital receivables terminology
Demonstrated service and success in team leadership, including team selection, performance evaluation, training and coaching
Advanced mastery of common reimbursement methodologies used by third party payers. * Business knowledge and results orientation within PFS. * Experience within a large academic teaching facility is desirable. *

Patient Financial Services Supervisor Resume Examples & Samples

Bachelors degree in Finance, Accounting, Healthcare Administration, Business or related area or equivalent education, training and/or experience required
Healthcare Financial Management Association (HFMA) Patient Accounts and Hospital Accounting Certification; CPAR certification, Advanced CPAR or CPAM preferred
Significant three plus (3+) years experience with one or more of the following

Patient Financial Services Team Leader Resume Examples & Samples

Reaching below shoulder level
Mousing
Lifting up to 10 pounds
Carrying up to 10 pounds
Effective communication skills with all levels, both verbal and written
Ability to perform under pressure and meet deadlines
Ability to keep neat and accurate files
Minimum 5 years experience in hospital and ambulatory care patient accounting with demonstrated above standard performance
Knowledge of benefits, covered services, billing and reimbursement procedures of all payor types, as well as working knowledge of the legal aspects of collection procedures, ICD-9 codes, national revenue codes, CPT codes, DRG codes, UB92 billing, and medical terminology
Experience and knowledge of on-line patient accounting systems with emphasis on IDX and/or hospital
Demonstrated leadership experience and/or special projects motivating a group of people
Bachelors Degree or equivalent knowledge/experience in related field

Patient Financial Services Manager Resume Examples & Samples

Strong relationship skills
Operational and people management
Knowledge of practice management and healthcare billing
Ability to work effectively on a team to coordinate assignments and meet clients goals in a fast pace environment
Ability to deal with ambiguity
Demonstrates the ability to work on multiple projects simultaneously and prioritize work to meet adapting deadlines
Excellent computer skills, including Microsoft Office suite
Ability to work overtime and irregular hours when needed
High level knowledge of physician practice workflow
Moderate level knowledge of medical practice management workflows
Experience in working across teams to plan, manage expectations, and deliver issue resolutions
Ability to interact proactively with all levels of the organization to drive quality improvement to deliver a better client experience
Self-motivated to seek and learn new information internally and in the industry to frame it for the client to appropriately plan and provide value to our clients

Patient Financial Services Representative Resume Examples & Samples

Manages large volume of inbound and outbound calls in a timely manner
Identify customers needs, clarify information, research issues and provide solutions and/or alternatives
Demonstrates ability to diffuse patient concerns and turn the call into a positive experience for our customers
Documents all conversations in our call center database/Epic/Zoll
Receives new insurance billing/demographic information and inputs into system to provide accurate billing and secure payments
Determines collectability of receivables and process accounts for collection agency referrals to ensure appropriate placement of accounts
Meets team quantitative and qualitative standards for productivity
Collects self pay receivables by phone or direct correspondence to ensure timely resolution of accounts
Ability to multi-task, set priorities and manage time effectively
Demonstrates good problem solving skills and critical thinking
Exhibits strong interpersonal skills when working with vendors, other health care facilities, law firms, and collection agencies
Actively participates in creating and implementing improvements
Minimum 2 years office experience, preferably in healthcare setting
Familiarity with CRM systems and practices
Knowledge of health insurance processes, preferred
Computer Skills Basic: Ability to use a computer and applications that are associated with performing basic work tasks (navigate in Windows, Outlook, etc)
Data Entry: Skilled in entering data and calculating items for processing; input of data into computer systems
Math Basic Skills: Knowledge and skills related to applying mathematical tools and methods for routine calculations
Records Management: Knowledge of appropriate data collection policy and procedures, filing systems, data management systems, and programs
Ability to compile, assimilate, organize, and store printed and electronic information

AVP, Patient Financial Services Resume Examples & Samples

Create and align Patient Financial Services’ goals and work plans with those of the institution and the Finance Department
Ensure optimal performance of the Epic system. Work collaboratively with IT and revenue-cycle leadership to improve
Manage staff to successfully achieve financial performance targets, e.g., revenue performance and critical indicators (AR, % cash to revenue, % bad debt, complaints); control departmental budget and spending
Manage all projects through a systematic approach that translates work plans into deliverables, with measurable outcomes, on a timely and cost-effective basis
Help directors and their staff resolve issues and assure accuracy and timeliness of billing, follow-up, adjustments, refunds, collections, and payment posting
Work with the Managed Care Department and third-party payors to ensure payment accuracy; analyze A/R and third-party rejections, and improve the process
Partner with the Revenue Integrity Department to ensure that the charge description master is accurate in regard to billing-related revenue and procedure codes
Routinely monitor AR reports to ensure timely and accurate billing. Evaluate unbilled receivables to ensure proper actions are taken to release claims promptly for reimbursement
Oversee evaluations and improvements to billing software by working collaboratively with the Information Technology Department and software vendors
Evaluate call-center performance and ensure that departmental responses are prompt and timely
Select and monitor the performance of external-vendor resources for services not provided by hospital staff or as an extension of the Hospital Business Office
Ensure compliance with all applicable regulatory requirements and standards, including Code of Conduct and Standards of Care
Manage and develop the department’s personnel; build and sustain a highly capable and engaged team and foster a team-centered culture
Solid experience (10+ years) at a senior level in patient accounting/services in a hospital is required. Major teaching/surgical hospital experience is highly desirable
Direct experience with all aspects of patient accounting, to include: inpatient and outpatient billing and collections, insurance verification, cash posting, precollections, and patient relations. Familiarity with patient registration is desirable
Demonstrated expertise in effectively managing Accounts Receivable to ensure that cash receipts are enhanced and bad debts minimized
Highly analytical and process driven, with a proven skill set in systems and data-driven healthcare performance improvement (Lean, Six Sigma, Baldrige, or other methods) is desirable
Technology and system savvy: excellent understanding of processes, systems, and databases; familiarity with Epic, Revenue Cycle and Relay health-claim systems is highly desirable; familiarity with coding and ICD-10 is a plus
Proven leadership skills and experience managing a large department through well-established performance management skills
Well organized and disciplined, with the ability to manage multiple priorities and projects. Experience leading/participating in hospital-wide projects and initiatives
Knowledgeable about the healthcare industry (e.g., managed care/revenue cycle) and translates that information into strategies that add value and improve operations
Outstanding written and oral communication skills; good listening capability; skilled at influencing a variety of people; can structure and effectively lead business meetings
Exceptional interpersonal skills; success at cultivating strong relationships with internal and external stakeholders and creating partnerships at all levels

Patient Financial Services Supervisor Resume Examples & Samples

Determines, coordinates and supervises daily staffing assignments and levels
Assesses quality of services delivered and facilitates staff development programs. Ensures staff compliance with departmental and organizational policies, procedures, and protocols
Performs staff responsibilities as needed to meet departmental goals. Leads the handling and resolution of complex issues and complaints
2 years experience in a healthcare setting with some progressive lead responsibilities

Associate Director of Patient Financial Services Resume Examples & Samples

Work in large central business office with approximately 75 staff
Bill and collect for 3 acute care facilities, multiple outpatient clinics and physician billing for clinics - Union and Non-Union staff
Manage daily operations of multiple levels of staff and multiple functions / departments across one or more business units
May include day to day site operations, management leadership internal and external to organization, accountable for financial and non-financial results (budgets and actuals)
Impact of work is most often at the operational or local business unit or market level
5 or more years of experience managing an acute care hospital business office
Acute and professional billing in large centralized business office
Proficient in Excel, Word and PowerPoint - preparing presentations for clients

Patient Financial Services Admitting Rep-fallon Resume Examples & Samples

1 year of experience in customer service
Excellent office software skills (Word, Excel, Outlook, etc.)
Preferred familiarity with medical terminology
May be assigned to a variety of admitting, registration and customer service work. Performs pre-registration/registration processes, verifies insurance coverage and obtains authorizations and notifications. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Obtains all necessary signatures and documentation required by the patients insurance plan
May calculate patient liability according to verification of insurance benefits, collects deposits and co-payments
Provides information and customer service to patients, patient families and visitors. Provides information and instructions to patients regarding hospital procedures and services. As required, assists patients with transport to their rooms
As assigned, provides reception and telecommunications operator services

Patient Financial Services Rep Resume Examples & Samples

Explains financial responsibilities for services received, payment options and collection procedures to patients and/or parties responsible for payment
Counsels patients regarding insurance benefits and recommends alternative sources of payment and/or financial assistance when appropriate
Contacts insurance carriers or other sources and acts as an advocate for the patient
Initiates process for collecting prepays due and performs follow-up to insure maximum collection is achieved
Two (2) years' medical/hospital business office, admission or insurance billing preferred. Understanding of medical insurance terminology

Manager Patient Financial Services Resume Examples & Samples

Sets monthly goals and provide data to Director of Patient Financial Services along with any accomplishments
Evaluates performance standards of the staff under direct supervision
Ensures that the department is operating within approved budgetary constraints
Responsible for all billing upgrades, testing, interfaces, reports for E-Premis,and Eclipses. Documents all patients’ accounts clearly and concisely of all activity
Responsible for managing vendor relations that pertain to Medicare and billing and overseeing and coordinating the processing for Medical Necessity and Correct Coding Initiative requirements
Oversees that claims and filed timely and are correct, oversee the process of working claim rejections and monitors daily and oversees the process of entering late charges and credits
Manages billing backlogs and develop corrective action plans
Oversee the error correction process, oversee secondary billing and meets standards established and monitor applicable job functions as stated in the Policies and Procedures
Monitor and take action necessary for aged accounts

Senior Director, Patient Financial Services Resume Examples & Samples

Revenue Cycle Management
Technology Systems Management
Quality and Compliance
5 yearsprior PFS experience
Ongoing education in Healthcare Management Administration, Revenue Cycle, Lean or six sigma and change management certification
MS Office (Word, Excel, PowerPoint, Visio, Project)
Master’s Degree (MPH, MPA, MBA) Preferred
Training/Courses in Accounts Receivable, AR management systems applications
Certified Healthcare Financial Professional (CHFP)
Large Health Systems

Director, Patient Financial Services Resume Examples & Samples

Allows documented standards and practices to ensure timely and accurate cash posting and application of accounts receivables adjustments, write-offs and account transfers. Approves write-off, adjustments and refunds within limits of AHS policy
Maintains appropriate programs and infra-structure to ensure a high level of customer satisfaction that includes patient friendly billing techniques, prompt service recovery and creation of an ideal patient experience. Investigates and promptly resolves patient problems or reported service dissatisfaction
Maintains appropriate programs and infra-structure to ensure a high level of employee engagement and satisfaction. Meets engagement score targets as measured by employee engagement surveys
Manages and meets the operating and capital budgets for assigned areas. Prepares departmental financial, operating and performance variance reports, and maintains internal policies and procedures
Recommends and facilitates the implementation of new and updated information systems specific to the needs of the revenue cycle; identifies and communicates system problems, enhancements, upgrades to all relevant staff and departments; develops partnerships with vendors to ensure the incorporation of best practices and maximization of current information system applications
Stay abreast of changing government billing regulations, new programs and revenue opportunities. Ensures that managers, supervisors, staff and billing vendors are current with required codes, bill forms, electronic claims processing tools and documentation rules
Through subordinate managers and supervisors, oversees and directs patient billing and collection activities including accounts receivable management, third party payer follow-up, claim submission, third party vendor management, appeals, and payment posting
Understands and applies third party payor contracting terms, oversees claims editing system edits and rules, monitors actual payments and denials against contractual terms and works with payers to reconcile under or over payments
Works with clinical departments and revenue enhancement staff to ensure compliance with all supporting documentation necessary for successful claims submission and reimbursement
Works with Patient Access, HIM, IT, clinical and other revenue enhancing departments to ensure compliance with all supporting documentation necessary for successful claims submission and reimbursement

Manager Patient Financial Services Resume Examples & Samples

4 year college degree or equivalent hospital leadership experience
3+ years in a related Healthcare Patient Accounting Field
Able to work in a high volume, fast paced work environment and perform and prioritize multiple tasks simultaneously
Proven proficiency or past experience in a management position, full understanding of cash posting, billing, credit, and collection functions, financial analysis, and third party payer procedures within a payer type (Commercial or Government)
Must have excellent verbal and written communication skills in order to present and explain information to customers in a desired manner consistent with procedures
Have practical experience working with Microsoft Word, Excel, PowerPoint, Access and Adobe applications
Have the ability to make independent decisions that are generally guided by established procedures and/or collection processes
Must be able to handle sensitive, stressful and confidential situations and account information
Need to have data / analytical skills to develop root cause and corrective action
Leadership experience in Healthcare Patient Accounting required

Patient Financial Services Analyst Resume Examples & Samples

Bachelor’s Degree in Healthcare Administration, Accounting, Finance or an allied field or equivalent combo of education and experience
Five (5) years previous related experience (i.e. hospital billing transplant)
Hospital based billing and collection processes
Previous experience in a large complex healthcare setting

Director of Patient Financial Services Resume Examples & Samples

5 years progressive leadership in customer collections, call center, or equivalent experience
Bachelor’s degree or equivalent experience in combination with an Associate’s degree
Proven leadership, people and communication skills
Microsoft Suite proficiency
Understanding of health care revenue cycle front-end, middle and back-end processes
10 years progressive leadership in customer collections, call center, or equivalent experience
Revenue cycle leadership experience
Experience with LEAN
Familiarity with EPIC

Patient Financial Services Representative Resume Examples & Samples

Attainment of performance proficiency in accordance with standards as specified in the Patient Account Representatives Situation Response Guidelines
Generation of transactions for reporting the managemen,t any written request received should be completed as appropriate
Advise patients of INOVA's collection processes for delinquent accounts
Add insurance coverage and information for billing
Knowledge of the requirements of medical authorizations
Knowledge of medical referrals
Knowledge of explanation of benefits (eob)
Knowledge of coordination of benefits (cob)
Researching of payments and posting errors for corrections
Ability to read, speak and write in the English Language in a clear and concise manner
Previous word processing experience with a minimum typing speed of 35 WPM
Previous computer experience is very helpful
Ability to sit speak clearly and wear a telephone headset for 8 hours with occasional breaks
Good manual dexterity. strength and health of hands, fingers and wrists
Adequate eyesight in order to read computer monitors
Ability to withstand occasional increased stress levels induced by agitated callers

Patient Financial Services CBO Senior Manager Resume Examples & Samples

Manages staff selects, trains, coaches, motivates, conducts performance evaluations, and oversees the workflow for staff. Develops goals and performance expectations for staff. Evaluates department processes and employee productivity using available statistical indicators. Manages the daily operations of the adjudication process. Ensures the daily operations of the Billing/ Collections and the adjudication process of an ongoing accounts Receivable Billing or Collections unit. Uses analysis results to detect developmental opportunities. Manages labor expenditures within budget guidelines
Interfaces with other Departments to resolve outstanding problem issues. Uses knowledge and experience to resolve matters escalated by staff. Conveys financial trends to appropriate parties and makes recommendations for improving performance. Interfaces with the Extended Business office, Home Care, and the Physician Billing offices to ensure account balances on single patient account (SPA) are correct.. including accurately identifying, transferring, refunding and researching the SPA accounts. Must interface with Denials team including Government RAC audits must have expertise regarding RAC process must ensure all payments/adjustments and refunds are processed correctly and timley. Interfaces with compliance to make sure all compliance projects are reviewed for accuracy and timeliness. Reviews and approves adjustments and controlled write offs
Ensures that fiscal policies and procedures and accepted accounting principles and practices are followed. Monitors contractual agreements to ensure compliance
Monitors activity results and conducts analyses of problems and/or trends. Reports identified issues to appropriate internal or external parties for correction
Monitors, analyzes and reports all financial data, as required. Produces required cyclical reports. Prepares analysis and summaries used for decision-making. Monitors trends and makes recommendations as appropriate
Serves as a knowledge resource to leaders and staff in solving complex or sensitive issues. Provides assistance and guidance with special projects
Conducts ongoing analysis of the department and employee productivity using available statistical indicators; uses analysis results to detect developmental opportunities. Develops and updates processes and procedures as appropriate. Achieves designated production and quality goals for the unit, and maintain s expenses within budgetary guidelines for the assigned units. Serves as knowledgeable resources

Manager of Patient Financial Services Resume Examples & Samples

Manages daily operations to assure accuracy, timely completion of assigned tasks, and achievement of area specific revenue cycle goals within budgeted expense guidelines
Diagnoses and solves issues impacting departmental objectives. Works collaboratively with other PFS and WPAHS departments, external agencies, vendors, and payers to achieve results by utilizing specialized revenue cycle expertise and communicating effectively in both written and verbal formats with staff, peers, all levels of management, and all encounters
Practices effective staff management in order to achieve desired departmental outcomes for operating results, employee job satisfaction, staff productivity, and leadership development. Supervises staff in a fair and consistent manner, evaluates work, and recommends and implements approved corrective actions
Fulfills the role as a dynamic leader within WPAHS and PFS to promote and support the achievement of overall organizational goals and specific revenue cycle objectives

Patient Financial Services Reimbusement Systems Analyst Resume Examples & Samples

Identifies and proposes resolution for systems issues or changes that impede timely and accurate billing of services and timely payment for those services
Assists with the analysis of data, and makes recommendations for improvement. Produces complex documents, performs analysis and maintains databases
Maintains and updates systems tables and databases critical for the functions, data output in the Patient Financial Services (PFS) billing system
Creates reports for financial reporting and analysis. Updates existing report formats to accommodate new reimbursement projects. Develops new methods of reporting, according to the changing needs of the department
Researches, corrects Statewide Planning and Research Cooperative System (SPARCS) and transaction errors in the PFS billing system and tracks errors to ensure that all accounts are correctly reported
Tests and troubleshoots system problems identified by various departments and hospital staff. Determines course of action for resolution and communicates resolutions and time frame back to departments and staff
Stays informed of regulatory requirement changes and keeps Siemens Contract Management (CM) application current. Assists in updating appropriate billing files to accommodate changes in regulations

Patient Financial Services Supervisor Resume Examples & Samples

A minimum of a High school diploma or equivalent required, college degree preferred
Minimum of one (1) year professional experience in a lead, training, or supervisory role within a related field preferred
Minimum of three (3) years of medical office billing, accounting, or similar financial experience required
Working knowledge of insurance terms, reimbursement methodologies, medical terminology, coding, billing and collection processes and accounting principles
Proficient in Microsoft Office programs
Supervises Patient Financial Services staff ensuring that service expectations are consistently met
Actively promotes compliance with performance standards, payer contracts, and regulatory requirements
Works collaboratively with departmental leadership, business partners, payers and other stakeholders when negative trends or opportunities are identified
Partners with the Revenue Cycle Director & PFS Management team on the development of new policies & standard work as needs are identified
Works in partnership with Finance and other business partners to ensure accurate reimbursement is obtained from payers using available tools

Patient Financial Services Representative Resume Examples & Samples

Obtain and enter accurate registration, demographic and insurance information for inpatient, partial, rent and ambulatory patients
Contact third party carrier to verify insurance coverage
Review admissions department data collection for thoroughness and accuracy of patient information
Interview all patients courteously for financial discussion and accurate completion of financial paperwork
Admit partial, rent and ambulatory patients
Assign appropriate plan code to the admission based on the insurance verification process
Calculate accurate rate reduction amounts based on Mclean hospital policy
Responsible for determining deposit amounts, collecting monies, and writing receipts
Monitor and rectify all problems associated with “hold bills” unbilled charges
Daily management and resolution of patient rep system work list
Effectively explain financial policies and procedures to patients and responsible parties
Act as a liaison between hospital, payers, vendors, patient accounts and patient
1-3 years of experience in customer service, admission, registration, insurance verification and financial counseling experience or previous physician office medical billing preferred
Proficient use of Excel, Word, EPIC experience preferred, adding machine use, and credit card terminals
Exceptional interpersonal skills to interview and obtain information from patients
Interact with Partners and Mclean hospital personnel, as well as, insurance administrators and vendors required
Excellent customer service skills, work independently and well organized
The analytical abilities to determine appropriate priorities where options may be limited and to gather information necessary to complete admission registration, financial counseling, and insurance information in a timely manner
Must have the ability to work in a fast paced area where the performance and concentration of multiple tasks simultaneously is required
HIPAA privacy guidelines
Must be able to speak and listen clearly

Manager of Patient Financial Services Resume Examples & Samples

Establishes adequate controls to ensure that gross patient service revenue is billed to third party carriers, government programs, grants and patients timely and accurately
Monitors and reports on key metrics such as cash collections, days outstanding, unbilled, denials, etc., in conjunction with the Director of Finance and other Finance leadership. Recommends and implements changes where appropriate after thoughtful and measurable analysis
Ensures achievement of group operating and strategic plans. Maintains effective communication with third party insurance carriers to resolve issues that impede cash flow and detract from patient/member satisfaction. Maintains effective communication with leadership to ensure that all third party compliance guidelines are met
Establishes and maintains controls for all cash collected and posted in Patient Accounting system. Responsible for oversight reconciliation process for cash
Serves as a key member of managed care group to ensure that standards and processes agreed to in contracts can be implemented timely and correctly. Provides input relative to contract performance and compliance. Mentors staff in career development. Provides timely feedback related to unit performance. Ensures that staff is kept informed about educational offerings
Has the authority to direct and support employees daily work activities. Has the direct responsibility to undertake the following employment actions: hiring, termination, corrective action and performance reviews
Knowledge:Ability to demonstrate broad and comprehensive knowledge of theories, concepts, practices and policies with the ability to use them in complex and/or unprecedented situations across multiple functional areas
Customer Service:Ability to lead operational initiatives to meet or exceed customer service standards and expectations in assigned unit(s) and/or across multiple areas in a timely and respectful manner
Knowledge of: Common Procedural Terminology (CPT), International Classification of Diseases (ICD-9), and Health Care Procedural Coding System (HCPCS) coding; documentation guidelines for medical services, patient case management, follow up and billing

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