Account Representative

Prime Healthcare Services • Harlingen, TX

105d

About The Position

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation's leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Requirements

• Ability to multi-task and prioritize needs to meet required timelines.
• Analytical, mathematical, and problem-solving skills preferred.
• Customer service experience preferred.
• Effective written and verbal communication skills.
• Experience in accounts payable, accounts receivable, or cashier experience preferred.
• Familiarity with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred.
• High School Graduate or GED Equivalent Required.
• Knowledge of basic understanding of medical coding and third-party operating procedures and practices.
• Knowledge of multiple insurance billing requirements and 6 months to 1 year of billing experience preferred.
• Medical and insurance terminology essential.

Responsibilities

• Posting all incoming payments to correct patient accounts on a daily basis.
• Inputting and retrieving data from computer systems.
• Reconciling accounts daily.
• Applying payments to patient accounts accurately and efficiently.
• Distributing all billing to appropriate personnel.
• Reviewing and performing follow-up on all authorizations and specialty referrals.
• Maintaining a current knowledge of contracts and state Worker's Compensation fee schedules.
• Handling incoming and outgoing mail pertaining to the hospital.
• Recognizing and correcting mailing errors immediately.
• Using proper tact and discretion in handling inquiries from patients and their families.
• Conducting accurate and timely payment analysis of managed care contracts to ensure appropriate reimbursement.
• Analyzing payments received from insurance companies to assure maximum and correct reimbursement of Hospital's receivables.
• Proactively working with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment.
• Utilizing and applying appropriate state and federal regulations to assure compliance in payment practices.
• Applying contractual adjustments to patient AR balances as needed.
• Managing and forwarding underpayments/denials to the appropriate departments for follow-up and further revenue collection as needed.

What This Job Offers

• Job Type: Full-time
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED