Patient Financial Services Representative I - York - Days

Duties and Responsibilities

Essential Functions:

• Conducts timely follow-up on patient accounts billed to insurance companies to determine reasons for delayed or missing payments.
• Investigates denied or rejected claims, reviews insurance remittance advice, and identifies reasons for denial.
• Collaborates with insurance carriers, internal billing teams, and other stakeholders to obtain necessary information and documentation to resolve claims.
• Documents findings and actions taken to resolve denials or delays in payment.
• Initiates and manages appeals or resubmissions of denied claims as appropriate.
• Communicates effectively, verbally and in writing, directly with payors to follow up on outstanding claims, files technical and clinical appeals. Resolves payment delays/non-payments to ensure timely and accurate reimbursement.
• Maintains accurate records of follow-up activities and payment status in the billing system.
• Identifies trends in denied claims and recommends process improvements to reduce denials and expedite payment.
• Provides excellent customer service to patients and internal teams regarding billing inquiries and insurance follow-up.

Common Expectations:

• Maintains appropriate records, reports, and files as required.
• Maintains established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards.
• Participates in educational programs and in-service meetings.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.