PFS Representative

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:
The Revenue Cycle Representative reconciles accounts, researches and resolves a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, sequencing of charges, and non-payment of claims.

Responsibilities:

*Reconciles accounts, researches and resolves a variety of issues relating to posting of payments and charges, insurance denials, secondary billing issues, sequencing of charges, and non-payment of claims.
*Evaluate and resolve errors on insurance claims for accurate and timely payments. Reviews updates to previously billed claims for accuracy.
*Edits claims within scope of authority (or escalate as needed) to meet and satisfy billing compliance guidelines.
*Audits payments and adjustments to resolve credit balances or overpayment.
*Posts payments (Insurance and/or Patient) and denials to patient invoices/accounts in a timely and accurate manner.
*Identifies and follows up on outstanding claims as documented in Electronic Medical Recordkeeping (EMR) system. Researches claims on payor portals as needed. Calls and discusses claims with payor representatives as needed.
*Prioritize work to ensure optimal accounts receivable performance and cash flow.

QUALIFICATIONS
Required
*Associate's degree or an equivalent combination of education and experience.
*Experience working in a healthcare or finance/accounting office.
*Proficient written and verbal communication.
Preferred
*Working knowledge of CPT and ICD-9/ICD-10 coding.
*Experience working in or with an Electronic Medical Recordkeeping (EMR) system such as EPIC.
*Experience and/or education/training in medical terminology.

Legal Employer: Pardee - HCHC

Entity: Pardee UNC Health Care

Organization Unit: Patient Accounting

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: PARDEESUPP

Exempt From Overtime: Exempt: No