This position coordinates the revenue cycle for the Pathways Service Line, including billing, insurance and self-pay collection through recommendation for write off or referral to outside collection agency / attorney. Protects Pathways from losses by providing timely, constructive feedback on processes that my adversely impact reimbursement.
Essential Job Duties:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Implements and remains current on all regulatory and governmental agency requirements regarding billing and reimbursement.
- Ensures maximum cash flow and protects Pathways from losses by billing and collection along with the revenue cycle functions of claims submission.
- Acts as a liaison with patients, other departments and fellow PFS teammates to obtain information related to claims processing and payment.
- Interacts with industry-wide peers, state, federal and local regulatory agencies to ensure compliance with billing and reimbursement requirements and statutes.
- Protects Pathways from financial losses by monitoring collection of accounts receivable and third party payments for correct reimbursement; resolves billing inquiries or problems.
- Obtains all health insurance information and appropriate authorizations needed for services as appropriate.
- Communicates with all departments as needed.
- Facilitates resolution of customer billing inquiries or problems, contacts patient and/or guarantor as appropriate.
- Facilitates refund requests as appropriate.
- Performs cash posting processes for accounts receivable including account pro-ration.
- Two years of experience performing accounts receivable.
- Requires a minimum of CRCS certification
Working Conditions, Equipment, Physical Demands:
There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.
Physical Demands -
Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.
The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.
The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.
Activation Date: Wednesday, June 24, 2020
Expiration Date: Friday, June 25, 2021