Patient Financial Services Representative 1

Overview

The Patient Financial Rep 1 is responsible for researching, resolving, documenting, and responding to inquiries related to hospital and professional accounts from patients, insurance companies, attorneys, public agencies, internal departments, employers, and third-party payers. This includes conference calls that have escalated between insurance companies and patients, looking for resolution of claims. Must maintain accurate and confidential records in compliance with HIPAA and organizational policies. Meet daily productivity and quality expectations and participate openly in departmental audit/review process to ensure that all work is monitored and completed based on departmental standards. Responsible for taking incoming calls, face to face interactions, and correspondence from patients and other third parties. Responsible for communicating the billing process, asking for payment on balances due including setting up payment arrangements, validating insurance coverage and addressing other billing concerns. Provides financial counseling for charity, presumptive eligibility screening, and assists with application process. Responsible for cash drawer balancing and daily deposit. Provides excellent customer service to patients regarding their financial obligations and billing concerns.

Responsibilities

Collaborate with internal departments (insurance teams, charging, collectors, financial assistance, patient care, patient access, and coding) to resolve account discrepancies. Researches, resolves, documents, and responds to patient account inquires generated from telephone, walk-in, virtual visits, MyCarle or written correspondence from external customers for Carle Health. Identifies and resolves insurance coverage errors, registration errors and billing errors to facilitate accurate and timely billing and payment processing. Identifies and reports account corrections needed for guarantor number changes (GNC's) double registrations, and other account build issues in the practice management system. Resolves patient underpayments, no payments, overpayments and undistributed payments for proper allocation. Process one-time payments and set up payment plans in accordance with hospital guidelines. Performs financial counseling, conducts charity screening through Experian, and assists patients in the process of applying for Carle Financial Assistance program. Responsible for cash drawer balancing and daily deposit. Maintain confidentiality and comply with HIPAA regulations. This includes reporting potential HIPAA breaches and Identity Theft. Recommend an adjustment when applicable or recommend a refund for overpayments to insurance carriers or patients, providing the appropriate documentation. Provides customer service for patients and insurance companies on conference calls. Identify problem accounts and escalate as appropriate. Responsible for meeting and exceeding departmental productivity quality assurance standards, and service excellence. Provide excellent customer service. Performs other duties as assigned.

Qualifications

Certifications: , Education: , Work Experience:

Carle Health Company Overview

Find it here.

Discover the job, the career, the purpose you were meant for. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.

Our more than 17,000 team members and providers work together to support patient care across central and southeastern Illinois.  We’ve grown to include seven, award-winning hospitals across eight hospital campuses and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We’re developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Methodist College. Carle Foundation Hospital, Carle Physicians Group, Carle Hoopeston Regional Health Center, Carle BroMenn Medical Center including Carle Eureka Hospital and associated Carle Health Medical Group clinics all hold Magnet® with Distinction designation, the nation’s highest honor for nursing care granted by the American Nurses Credentialing Center (ANCC). Carle Health Methodist Hospital, Carle Health Proctor Hospital and Carle Health Pekin Hospital all hold the exclusive Magnet® designation.

We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: [email protected].

Salary Range

The compensation range for this position is $17.26per hour - $27.96per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.