The Patient Financial Services Payment Review position is responsible for debit and credit payment variance reviews. The Payment Specialist works independently and is responsible for the review of complex managed care contracts and reimbursement methodologies, ensuring accurate overpayment and underpayments are documented. Applies independent judgment and knowledge to audit third-party payer payment disputes. Documents and/or notifies management of preventive measures in response to payment trends identified through analysis of claims data. Works with management staff identifying corrective measures necessary to resolve problems. Understands and utilizes many complex and varying California and Federal Statutes and regulations, guidelines and systems to ensure appropriate billing and collections are in compliance. The Payment Specialist will manage resources responsibly. The position is essential to Patient Financial Services accurately capturing and recovering hospital revenue timely and efficiently.
This position offers you the opportunity to work from home (WFH) after all training has been completed. Once completed you will need to be available to come into the office for additional training, meetings etc., as needed.