Patient Financial Services Representative

Lifepoint Health; Northern (KY); Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Comprehensive Benefits

401(k) with company match

Tuition assistance

Job summary

Lifepoint Health is seeking a remote Patient Financial Services Representative to support hospital billing operations. You will manage claims processing, follow up on insurance payments, and address denials to maximize cash flow across our Health Support Center.

Ideal candidates have 4+ years in insurance billing, familiarity with Medicare compliance, and experience with IVANS and DDE systems. Strong attention to HIPAA and CMS regulations is required.

Qualifications

• High School diploma or equivalent required.
• Minimum of 4 years in Insurance Billing/Follow up required.
• Coding experience preferred.

Responsibilities

• Ensure collection of funds for all hospital billable services.
• Support Director of Patient Accounting to maximize income through cash management.
• Maintain accuracy in claims processing (paper and electronic).
• Follow up on accounts to ensure timely payments.
• Explain charges and insurance payments to patients.
• Develop relationships with third party payers and vendors to maximize cash flow.
• Inquire and seek explanations for denials/rejections.
• Adhere to HIPAA regulations.
• Maintain Medicare rejections via IVANS and rekey via DDE system daily.
• Maintain CMS billing rules knowledge.
• Handle complex billing issues.
• Manage Medicare Bad Debt Log for monthly submission.
• Manage Patient Financial Services Denial Log.
• Submit primary Medicare First Level Appeals after PFSD approval.

Skills

Insurance billing

Accounts receivable

HIPAA compliance

Denials management

Cash collection

CMS rules knowledge

Education

High School diploma or equivalent

Associate degree preferred

Tools

IVANS system

DDE system

Job description

Schedule: Days: M-F

Job Location Type: Remote

Your experience matters

At Lifepoint Health, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. As a member of the Health Support Center (HSC) team, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members to positively impact our mission of making communities healthier®.

More about our team

A Patient Financial Services Representative is responsible for completing insurance claims for patient services, follow-up on the claims to ensure payment is made promptly and accurately. Ensure Medicare rejections from IVANS are worked daily and rekeyed via DDE system. Maintains knowledge of CMS billing rules and regulations. Responsible for complex billing issues. Manage Medicare Bad Debt Log. Manage Patient Financial Services Denial Log. Responsible for primary Medicare First Level Appeal Submission after approval from PFSD.

How you'll contribute

A Patient Financial Services Representative who excels in this role:

• Ensures the collection of funds for all hospital billable services so that goals are met in Bad Debts, AR Days and Cash collections
• Supports the Director of Patient Accounting to maximize the income earned through cash management
• Maintains accuracy in claims processing paper and electronic claims
• Maintains follow-up on accounts to ensure claims are paid promptly and correctly
• Explains patient inquiries regarding hospital charges, insurance payments or insurance coverage
• Develops a relationship with third party payers, and venders to ensure cash flow is maximized
• Inquires and seeks explanations for all denials and/or rejections
• Adheres to standards set forth by Health Insurance Portability and Accountability Act (HIPAA) of 1996
• Ensures Medicare rejections from IVANS are worked daily and rekeyed via DDE system
• Maintains knowledge of CMS billing rules and regulations
• Be responsible for complex billing issues
• Managed Medicare Bad Debt Log for Monthly submission: Reviews Medicaid remits daily for Medicare qualifying accounts and PFSD will give agency returns for account review of accounts > 120 for logging
• Manages Patient Financial Services Denial Log
• Be responsible for primary Medicare First Level Appeal Submission after approval from PFSD

Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

• Comprehensive Benefits:Multiple levels of medical, dental and vision coverage for full-time andpart-time employees.
• Financial Protection & PTO:Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Financial & Career Growth:Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Employee Well-being:Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Professional Development:Ongoing learning and career advancement opportunities.

What we're looking for

• High School diploma or equivalent required, Associate's degree or higher preferred
• Minimum of 4 years in Insurance Billing/Follow up required
• Coding experience preferred

EEOC Statement

"Lifepoint Health is an Equal Opportunity Employer." Lifepoint Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."

You must be authorized to work in the United States without employer sponsorship.

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.