layiq

/la·yiq/adjective

worthy; deserving; fitting; suitable.

A role, opportunity, or path that merits attention, time, and pursuit.

LAYIQ - Patient Financial Services Representative - Patient Financial Services - FT - Day at Stormont-Vail HealthCare

Responsible for the processing of patient accounts after initial bill submission to final 3rd party payment resolution. This responsibility includes timely and accurate resolution of denied claims and insurance correspondence and follow-up on unpaid claims exceeding the clean claim payment cycle.
Processes patient accounts from uploading into the clearinghouse application through final claim submission, both manual and electronic. This responsibility includes resolving remaining bill edit failures, claim submission, receipt reconciliation and rebilling when necessary.
Collects, validates, and updates patient’s comprehensive data set and documenting in the registration system, completing electronic insurance verifications, identifying managed care issues and referring as appropriate for resolution, obtaining appropriate signatures to satisfy legal and health system requirements and completion of required forms including Medicare MSP.
Identifies and notifies management of customer service issues and potential process/system problems that cause billing and payment errors and assists in improvement implementation as requested.
Accurately and efficiently distributes and/or prepares various reports; processes account credit balances, refund requests, cash transfers, returned checks and unidentified payments in a timely manner.
Accurately posts payments and adjustments and balances all entries according to payer cash processing and reconciliation procedures.
Answers questions from other staff or clinic offices by phone or e-mail in a timely manner.
Consistently and accurately documents accounts with activities as needed in a timely manner.
Analyzes and resolves insurance correspondence for unpaid claims. Validates accuracy of insurance information and completed insurance verification for specific payors that do not participate in electronic eligibility by established procedures (phone calls, websites, etc.).
Completes manual billing process for claims that cannot be sent electronically.
Creates encounters for Physicians providing Hospital professional services including but not limited to ED professional fees, Hospital visits, Invasive procedures, Hospitalists, Radiologists, Therapies (including Chemo & Radiation), Counseling, etc.
Generates re-bills after all edits have been resolved and re-submits claims to third-party payor.
Identifies and correctly resolves all electronic claim edits failures in a timely manner.
Identifies missing or incorrect requirements of rejected claims and either resolves or forwards promptly to appropriate staff for resolution.
Monitors and completes patient accounts on billing hold for additional information within ten business days.
Reviews and resolves unbilled encounter report. Reviews Hospital cards/interface charges/electronic charge sheets, etc. for accuracy and resolves missing/incorrect information as necessary. Reviews Posting & Exception Reports and verifies that information has been accurately recorded on the account receivable system.
Required for All Jobs
Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health
Performs other duties as assigned
Patient Facing Options
Position is Not Patient Facing
Remote Work Guidelines
Workspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards.
Stable access to electricity and a minimum of 25mb upload and internet speed.
Dedicate full attention to the job duties and communication with others during working hours.
Adhere to break and attendance schedules agreed upon with supervisor.
Abide by Stormont Vail’s Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually.
Remote Work Capability
Hybrid
Scope
No Supervisory Responsibility
No Budget Responsibility No Budget Responsibility
Physical Demands
Balancing: Occasionally 1-3 Hours
Carrying: Occasionally 1-3 Hours
Climbing (Ladders): Rarely less than 1 hour
Climbing (Stairs): Rarely less than 1 hour
Crawling: Rarely less than 1 hour
Crouching: Rarely less than 1 hour
Driving (Automatic): Rarely less than 1 hour
Driving (Standard): Rarely less than 1 hour
Eye/Hand/Foot Coordination: Frequently 3-5 Hours
Feeling: Occasionally 1-3 Hours
Grasping (Fine Motor): Frequently 3-5 Hours
Grasping (Gross Hand): Frequently 3-5 Hours
Handling: Occasionally 1-3 Hours
Hearing: Frequently 3-5 Hours
Kneeling: Occasionally 1-3 Hours
Lifting: Occasionally 1-3 Hours up to 30 lbs
Operate Foot Controls: Rarely less than 1 hour
Pulling: Occasionally 1-3 Hours up to 30 lbs
Pushing: Occasionally 1-3 Hours up to 30 lbs
Reaching (Forward): Occasionally 1-3 Hours up to 30 lbs
Reaching (Overhead): Occasionally 1-3 Hours up to 30 lbs
Repetitive Motions: Frequently 3-5 Hours
Sitting: Frequently 3-5 Hours
Standing: Occasionally 1-3 Hours
Stooping: Rarely less than 1 hour
Talking: Occasionally 1-3 Hours
Walking: Occasionally 1-3 Hours
Working Conditions
Burn: Rarely less than 1 hour
Chemical: Rarely less than 1 hour
Combative Patients: Rarely less than 1 hour
Dusts: Rarely less than 1 hour
Electrical: Rarely less than 1 hour
Explosive: Rarely less than 1 hour
Extreme Temperatures: Rarely less than 1 hour
Infectious Diseases: Rarely less than 1 hour
Mechanical: Rarely less than 1 hour
Needle Stick: Rarely less than 1 hour
Noise/Sounds: Rarely less than 1 hour
Other Atmospheric Conditions: Rarely less than 1 hour
Poor Ventilation, Fumes and/or Gases: Rarely less than 1 hour
Radiant Energy: Rarely less than 1 hour
Risk of Exposure to Blood and Body Fluids: Rarely less than 1 hour
Risk of Exposure to Hazardous Drugs: Rarely less than 1 hour
Hazards (other): Rarely less than 1 hour
Vibration: Rarely less than 1 hour
Wet and/or Humid: Rarely less than 1 hour
Stormont Vail is an equal opportunity employer and adheres to the philosophy and practice of providing equal opportunities for all employees and prospective employees, without regard to the following classifications: race, color, ethnicity, sex, sexual orientation, gender identity and expression, religion, national origin, citizenship, age, marital status, uniformed service, disability or genetic information. This applies to all aspects of employment practices including hiring, firing, pay, benefits, promotions, lateral movements, job training, and any other terms or conditions of employment.
Retaliation is prohibited against any person who files a claim of discrimination, participates in a discrimination investigation, or otherwise opposes an unlawful employment act based upon the above classifications.

Patient Financial Services Representative - Patient Financial Services - FT - Day

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