Patient Account Representative
Patient Account Representative
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Job Description
Overview
Prime Healthcare is an awardwinning health system headquartered in Ontario California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nations leading health systems with nearly 50000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation a 501(c)3 notforprofit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race color sex sexual orientation gender identity religion national origin age (subject to applicable law) disability military status genetic information or any other basis protected by applicable federal state or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: Notice for California Applicants: 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 followup on all authorizations and specialty referrals. Maintains a current knowledge of contracts and state Workers 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 Hospitals receivables. Proactively works with payers and inhouse 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 followup and further revenue collection as needed.
Qualifications
1. Ability to multitask prioritize needs to meet required timelines
2. Analytical mathematical and problemsolving 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 thirdparty 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 $24.00. 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.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
