PFS Account Representative Level 1

Patient Financial Service Account Representative

Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Location : Streeterville, Chicago, IL

Job Description

A Patient Financial Service (PFS) Account Representative works as the last stop on the Revenue Cycle of the hospital. Therefore he / she holds all upstream areas (from our registrars to our clinicians to our coding team) accountable if a breakdown were to occur, or if pertinent information needed for billing is missing. A PFS representative is oftentimes the liaison between the hospital and the payer and is ultimately responsible for the reimbursement that is owed. The success of a PFS representative directly impacts and correlates to the hospital's bottom line and allows Lurie Children's to fulfill our mission of serving children in need. Specifically, a PFS representative serves as the main contact for all patient / families, third parties, and related Lurie Children's departments, analyzing and resolving all billing, collection, and customer inquiry needs. Responsible for the timely and accurate resolution of hospital accounts and the collection of reimbursement to maintain hospital operations. Routinely uses the patient accounting system, electronic claims systems, office software, verbal and written skills to expedite resolution of claims and issues.

Job Duties

• Create and submit all billing to Government entities, private insurance payers and families; consistent with Federal, State and insurance specific requirements.
• Resolve all assigned claim edits generated by Epic, the clearinghouse or the payor. Develop strategy to reduce claim edits by collaborating with management and other departments.
• Identifies Registration, Demographic and Insurance information problems makes all necessary updates. This includes eligibility verification and referral retrieval.
• Resolve assigned denials and variances, accurately determining the root cause and collaborating to reduce the denial or variance.
• Ensure that all claims issued timely and are received by the payers.
• Process assigned inbound correspondence and telephone inquiries from patients and insurance carriers. Promptly responding in writing or verbally. This includes researching and processing of charge revisions, corrections, adjustments, discounts associated with disputes.
• Process internal payment transfers between Hospital and Patient Billing, process refund requests for families, governmental and third-party payors.
• Interacts with Health Information Management, Case Management on claim submission issues which can include obtaining the appropriate Medical Record, or validation of coding.
• Other job functions as assigned.

Knowledge, Skills, and Abilities

Education

High School Diploma / GED (Required)

Pay Range

$19.50-$30.23 Hourly

At Lurie Children's, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children's offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs.

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes :

There's a Place for You with Us

At Lurie Children's, we embrace and celebrate building a team with a variety of backgrounds, skills, and viewpoints recognizing that different life experiences strengthen our workplace and the care we provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care.

Lurie Children's and its affiliates are equal employment opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.