The primary function of the Patient Financial Services Reimbursement Analyst is to maintain accurate and timely claim submission for a designated groups of accounts. Under the supervision of the Office Coordinator, the PFS Reimbursement Analyst:
- Ensures accurate, timely and compliant claim submission, including confirmation of electronic and hard-copy billing of any delinquent claims; rebilling and follow-up of all delinquent claims.
- Responds to all patient and payer inquiries, denials, correspondence and telephone inquires.
- Maintains all reports (contract management) files and records as needed; i.e., medical records, referrals, precertification letters etc.
- Advises other areas of updated insurance information and claim denials; i.e., registration.
- Adjusts account balances to specific account needs; i.e., capitated labs.
- Applies cash received to appropriate accounts. Refunds all overpayments as necessary.