Patient Account Representative

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Job description

Overview:
Prime Healthcare stands apart from others by its unique ability to save and transform hospitals. We have been named the "fastest-growing hospital system" in the country by Modern Healthcare. And as we continue to grow and fulfill our mission of "saving hospitals, saving jobs and saving lives," we remain committed to delivering exceptional care, and creating a legacy that will improve healthcare.

Prime Healthcare and the not-for-profit Prime Healthcare Foundation employ nearly 50,000 employees and physicians and own and operate 45 acute care hospitals in Alabama, California, Florida, Georgia, Indiana, Kansas, Michigan, Missouri, Nevada, New Jersey, Ohio, Pennsylvania, Rhode Island, and Texas.

If you wish to contribute to the Prime Healthcare legacy within an Administrative support capacity within our family of acute care hospitals (or one of our future hospitals), then join our talent network to begin exploring immediate and future opportunities.

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Responsibilities:
The Patient Account Rep I is responsible for posting all incoming payments to correct patient accounts on a daily basis. Inputs and retrieves data from computer systems. Reconciles accounts daily. Applies payments to patient accounts accurately and efficiently. Distribution of all billing to appropriate personnel. Reviews and performs follow-up on all authorizations, and specialty referrals. Maintains a current knowledge of contracts and state Worker's Compensation fee schedules. Responsible for the handling of incoming and outgoing mail pertaining to the hospital. Needs to have ability to recognize and correct mailing errors immediately. Always uses proper tact and discretion in handling inquiries from patients and their families. The Patient Account Rep I is responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospital's receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate California and Federal regulations in order to assure compliance in payment practices. Responsible for posting all incoming payments to correct patient accounts on a daily basis. Inputs and retrieves data from computer systems. Reconciles accounts daily. Applies payments to patient accounts accurately and efficiently. Applies contractual adjustments to patient AR balances as needed. Manage and forward underpayments /denials to the appropriate departments for follow-up and further revenue collection as needed.

Qualifications:

1. Ability to multi-task, prioritize needs to meet required timelines
2. Analytical, mathematical and problem-solving skills required
3. Customer Services experience required
4. Effective written and verbal communication skills
5. Experience in accounts payable, accounts receivable or cashier experience preferred
6. Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred
7. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
8. Knowledge of basic understanding medical coding and third-party operating procedures and practices
9. Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience required
10. Medical and Insurance terminology essential

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $21.00 to $28.00. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

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