Patient Financial Services Representative I

WellSpan Health; York (York County); On-site; USD 42,000 - 58,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement savings plan

Paid time off (PTO)

Education assistance

DailyPay

Expanded Paid Parental Leave

Job summary

WellSpan Health is seeking a Revenue Cycle Specialist to complete assigned tasks and assist in submitting electronic or manual insurance claims. You will follow up on accounts, resolve denials, and communicate with third-party payers to ensure timely reimbursement according to current regulations.

This is a full-time, 40-hour weekly role with a Monday–Friday dayshift. The ideal candidate has a HS diploma or GED (Associates preferred) and 1 year of relevant billing experience, with strong

Qualifications

• Knowledge of insurance claims processing, payer policies, and medical terminology.
• Strong analytical and problem-solving skills to investigate and resolve billing discrepancies.
• Excellent verbal and written communication skills for interaction with insurance companies and internal teams.
• Proficiency with billing software and Microsoft Office Suite (Excel, Word, Outlook).

Responsibilities

• Conduct timely follow-up on patient accounts billed to insurance companies to determine reasons for delayed or missing payments.
• Investigate denied or rejected claims, review remittance advice, and identify reasons for denial.
• Collaborate with insurance carriers, internal billing teams, and other stakeholders to obtain necessary information and documentation to resolve claims.
• Document findings and actions taken to resolve denials or delays in payment.
• Initiate and manage appeals or resubmissions of denied claims as appropriate.
• Communicate with payors to follow up on outstanding claims and to file necessary appeals.
• Maintain accurate records of follow-up activities and payment status in the billing system.
• Identify trends in denials and recommend process improvements to reduce denials and expedite payment.
• Provide outstanding service to patients and internal teams regarding billing inquiries and insurance follow-up.

Skills

Insurance claims processing

Analytical problem solving

Verbal and written communication

Billing software proficiency

Microsoft Office Suite

Multi-account management

Attention to detail

Education

High School Diploma or GED

Associates Degree Preferred

Job description

General Summary

Completes assigned revenue cycle tasks. Assists in the completion of submitting electronic and/or manual insurance claims, resolves claim edits, performs insurance account follow-up, researches claim denials for resolution and submits disputes and appeals when necessary. Represents the System in a professional manner while interacting with peers, leaders, patients, and third-party payers to achieve timely payment on accounts in accordance with current government and payer regulations.

Job Description

Full time (40 hours weekly)

Monday-Friday dayshift

General Summary

Completes assigned revenue cycle tasks. Assists in the completion of submitting electronic and/or manual insurance claims, resolves claim edits, performs insurance account follow-up, researches claim denials for resolution and submits disputes and appeals when necessary. Represents the System in a professional manner while interacting with peers, leaders, patients, and third-party payers to achieve timely payment on accounts in accordance with current government and payer regulations.

Duties and Responsibilities

• Conducts timely follow-up on patient accounts billed to insurance companies to determine reasons for delayed or missing payments.
• Investigates denied or rejected claims, reviews insurance remittance advice, and identifies reasons for denial.
• Collaborates with insurance carriers, internal billing teams, and other stakeholders to obtain necessary information and documentation to resolve claims.
• Documents findings and actions taken to resolve denials or delays in payment.
• Initiates and manages appeals or resubmissions of denied claims as appropriate.
• Communicates effectively, verbally and in writing, directly with payors to follow up on outstanding claims, files technical and clinical appeals. Resolves payment delays/non-payments to ensure timely and accurate reimbursement.
• Maintains accurate records of follow-up activities and payment status in the billing system.
• Identifies trends in denied claims and recommends process improvements to reduce denials and expedite payment.
• Provides excellent customer service to patients and internal teams regarding billing inquiries and insurance follow-up.

Common Expectations

• Maintains appropriate records, reports, and files as required.
• Maintains established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards.
• Participates in educational programs and in-service meetings.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

QUALIFICATIONS

Minimum Education

• High School Diploma or GED Required
• Associates Degree Preferred

Work Experience

• 1 year Required
• Prior experience in hospital billing, professional billing, or insurance follow-up/denials Preferred

Knowledge, Skills, And Abilities

• Knowledge of insurance claims processing, payer policies, and medical terminology is essential
• Strong analytical and problem-solving skills to investigate and resolve billing discrepancies
• Excellent verbal and written communication skills for effective interaction with insurance companies and internal teams
• Proficiency with billing software and Microsoft Office Suite (Excel, Word, Outlook)
• Ability to manage multiple accounts and prioritize tasks efficiently in a fast-paced environment
• Attention to detail and commitment to accuracy

Benefits Offered

• Comprehensive health benefits
• Retirement savings plan
• Paid time off (PTO)
• Education assistance
• Financial education and support, including DailyPay
• Expanded Paid Parental Leave

For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org)

About Us

WellSpan Health’s vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region’s largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.