Rancho Health
Revenue Cycle Patient Financial Advisor
Rancho Health - Temecula, California, United States, 92591
Work at Rancho Health
Overview
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Overview
Job Summary:
The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.
Job Summary:
The Patient Financial Advisor (PFA) is responsible for ensuring a positive patient experience, by helping patients understand their bill and assisting patients with billing related inquiries. The PFA understands guidelines for setting up payment plans, soft collections, and bad debt collections. The PFA will also help ensure accurate, timely filing of medical claims and bills to various payers and patients. This process includes review of medical encounter notes, for appropriate procedure codes, diagnoses, and modifiers. The candidate works with the collection and statement vendors on patient collection activities. The PFA understands the full revenue cycle including billing, payment posting, AR follow up, and financial reconciliation. The PFA is expected to meet monthly revenue cycle call volume and collection goals. Candidate can communicate effectively with providers and clinical staff on insurance billing and documentation guidelines. The PFA serves as a resource to appointment and registration staff regarding appropriate insurance selection, assisting patients with understanding statements and collection policies. Other job duties as assigned.
Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Manages phone lines and responds to patient calls and questions. Manages chat lines and responds to Operations inquiries. Detailed documentation of calls, conversations and chats in the patient medical record. Assist patients by following up on unpaid and denied claims. Reviewing medical documentation and billing for errors, to ensure a clean claim is submitted the first time Required education and experience: The requirements listed below are representative of the knowledge, skills, and/or ability required.
Minimum Education required:
High school diploma or equivalent (GED). Medical billing or coding certification is preferred. Minimum Experience Required:
Required 5 years of revenue cycle experience 2 years of customer service experience in the healthcare setting, preferably in RCM Knowledge of Epic EMR software is a plus Minimum Knowledge and Skills Required:
Exceptional verbal and written communication skills: Ability to communicate effectively and congenially with patients and staff members in person, via messaging systems, and over the phone Ability to exercise tact, initiative, and good judgement when interacting with patients and staff members Understanding and proficient use of medical billing guidelines and regulations. Knowledge of regulations as set forth by CMS, OIG, commercial insurances and other regulatory agencies. Knowledge of CPT, ICD-10, and HCPCS codes, as well as appropriate modifier usage for billing and following up on open AR claims. Familiar with billing all major medical insurances, including Medicare, Tricare, and commercial payers Working experience in Office 365 business tools such as Outlook, Excel, Word etc. Ability to navigate and accurately input within the Practice Management System Ability to navigate in the EMR and other source systems Ability to accept supervision and feedback. Ability to look for patterns of events, provides feedback and solutions Critical thinking and analytical skills to review accounts and medical documentation.
Travel:
0%
Work Authorization : Must be authorized to work in the United States.
8am - 5pm M-F
The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.
Job Summary:
The Patient Financial Advisor (PFA) is responsible for ensuring a positive patient experience, by helping patients understand their bill and assisting patients with billing related inquiries. The PFA understands guidelines for setting up payment plans, soft collections, and bad debt collections. The PFA will also help ensure accurate, timely filing of medical claims and bills to various payers and patients. This process includes review of medical encounter notes, for appropriate procedure codes, diagnoses, and modifiers. The candidate works with the collection and statement vendors on patient collection activities. The PFA understands the full revenue cycle including billing, payment posting, AR follow up, and financial reconciliation. The PFA is expected to meet monthly revenue cycle call volume and collection goals. Candidate can communicate effectively with providers and clinical staff on insurance billing and documentation guidelines. The PFA serves as a resource to appointment and registration staff regarding appropriate insurance selection, assisting patients with understanding statements and collection policies. Other job duties as assigned.
Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Manages phone lines and responds to patient calls and questions. Manages chat lines and responds to Operations inquiries. Detailed documentation of calls, conversations and chats in the patient medical record. Assist patients by following up on unpaid and denied claims. Reviewing medical documentation and billing for errors, to ensure a clean claim is submitted the first time Required education and experience: The requirements listed below are representative of the knowledge, skills, and/or ability required.
Minimum Education required:
High school diploma or equivalent (GED). Medical billing or coding certification is preferred. Minimum Experience Required:
Required 5 years of revenue cycle experience 2 years of customer service experience in the healthcare setting, preferably in RCM Knowledge of Epic EMR software is a plus Minimum Knowledge and Skills Required:
Exceptional verbal and written communication skills: Ability to communicate effectively and congenially with patients and staff members in person, via messaging systems, and over the phone Ability to exercise tact, initiative, and good judgement when interacting with patients and staff members Understanding and proficient use of medical billing guidelines and regulations. Knowledge of regulations as set forth by CMS, OIG, commercial insurances and other regulatory agencies. Knowledge of CPT, ICD-10, and HCPCS codes, as well as appropriate modifier usage for billing and following up on open AR claims. Familiar with billing all major medical insurances, including Medicare, Tricare, and commercial payers Working experience in Office 365 business tools such as Outlook, Excel, Word etc. Ability to navigate and accurately input within the Practice Management System Ability to navigate in the EMR and other source systems Ability to accept supervision and feedback. Ability to look for patterns of events, provides feedback and solutions Critical thinking and analytical skills to review accounts and medical documentation.
Travel:
0%
Work Authorization : Must be authorized to work in the United States.
8am - 5pm M-F