BILLING REPRESENTATIVE - DENALI CENTER - Foundation Health, LLC : Job Details

This position serves as a primary resource in complex and/or sensitive cases and may be assigned to work in any position in the department based on the departmental need. Provides leadership support to the patient financial services team and facilitates patient billing and collection activities, following patient accounts through the billing process to the payor, working with the payor through claims processing, ensuring reimbursement to the facility.

About Fairbanks Memorial HospitalFairbanks Memorial Hospital is a non-profit facility owned by the Greater Fairbanks Community Hospital Foundation. A Joint Commission-accredited facility with 152 licensed beds, Fairbanks Memorial Hospital is the primary referral center for residents of Alaska's interior with a strong patient-to-nurse ratio and Shared Leadership Infrastructure. In addition to our exceptional clinical environment, our location offers incomparable lifestyle rewards away from work. In Fairbanks, small-town living, spectacular natural beauty and endless recreation combine to create a one-of-a-kind place to live, work and play.

• Provides subject matter expertise in specialized areas, leadership, and training to Patient Financial Services Representatives. Provides leadership for the team by successfully leading special projects, training staff, providing suggestions to improve processes and serving as a resource for complex and sensitive accounts.
• Identifies and communicate to leadership any opportunities to improve work processes.
• As assigned, processes payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing.
• As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility contracts, payor customer service, provider representatives, spreadsheets and the companys collection/self-pay policies to ensure maximum reimbursement.
• As assigned, researches payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary.
• Builds strong working relationships with assigned business units, hospital departments or provider offices.
• Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems.
• Conducts routine audits to identify errors. Provides guidance and reeducation support for billing office staff.
• Responds to incoming calls and makes outbound calls as required to resolve billing and payment issues.
• Reduces Accounts Receivable balances. Works as a member of the patient financial services team to achieve goals in days and dollars of outstanding accounts.
• Uses systems to provide statistical data, prepare issues list(s) and to communicate with payors accurately.
• May serve as a backup in the absence of PFS Supervisor(s) to ensure the department operations are efficiently and effectively maintained.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Foundation Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.

• Associates degree in healthcare, business or related field or equivalent working knowledge.
• Requires knowledge of patient financial services, or financial collecting services or insurance industry experience processes normally acquired over five (5) or more years of work experience.
• Successful completion of a medical billing certification program from an accredited organization, association, or university within twelve (12) months of hire/transfer required.
• Must be able to organize and prioritize work. Must demonstrate good judgment, initiative, problem-solving abilities, and effective time management. Must demonstrate professional verbal and written communication skills. Must be able to work with minimal supervision and within a team environment.
• Requires knowledge of medical terminology and a broad understanding of all common insurance and payor types and authorization requirements.

PREFERRED QUALIFICATIONS

• Medical billing and/or coding certificate preferred. Experience coordinating work functions of groups of individuals is preferred.
• Additional related education and/or experience preferred.

Foundation Health Partners is an EEO/AAP employer; qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.