Patient Account Rep 1

Scotland Health Care System in Laurinburg, North Carolina•Laurinburg, NC

2d•Onsite

About The Position

Scotland Health Care System, a community-owned, not-for-profit organization founded in 1946 and serving Laurinburg, North Carolina, is seeking a dedicated professional for the Patient Account Rep 1 role within the Patient Financial Services Department. This full-time position operates on the 1st shift and involves examining denied and underpaid claims, analyzing payer discrepancies, and contributing to strategies for reducing accounts receivable. The role requires maintaining knowledge of federal and state regulations, payer requirements, and explanation of benefits, while also documenting payer interactions and handling communication with payers and internal departments. The position is part of a continuous quality improvement process and encourages initiative in identifying and communicating trends to management. The role also includes cross-training in other Patient Accounts areas, participation in HBI Revenue Cycle classes, and ensuring compliance with HIPAA guidelines.

Requirements

Knowledge of federal and state regulations.
Understanding of specific payer requirements and explanation of benefits.
Ability to identify and report billing compliance issues and payer discrepancies.
Proficiency in updating and maintaining accurate payer files.
Skill in thoroughly documenting all interactions with payers.
Effective communication skills for handling telephone and email correspondence.
Ability to participate in continuous quality improvement efforts.
Demonstrates initiative and resourcefulness.
Willingness to be cross-trained in other areas within Patient Accounts.
Willingness to participate in HBI Revenue Cycle classes.
Understanding and maintenance of compliance with HIPAA guidelines when handling patient information.

Responsibilities

Examines denied and underpaid claims to determine reasons for discrepancies.
Provide payers with specific reasons for the suspected underpayments and analyzes denial reasons given by payers.
Works with management to identify, trend and address root causes of denials; helps pinpoint strategies for reducing AR.
Maintains a thorough knowledge and understanding of federal and state regulations, as well as specific payer requirements and explanation of benefits, in order to identify and report billing compliance issues and payer discrepancies.
Updates and maintains accurate files on each payer including contact names, addresses, phone numbers, web sites and other pertinent information thoroughly documents all interactions with payers.
Effectively handles all communication, including telephone and email from payers and departments within Revenue Cycle.
Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with manager and tracking progress (attends huddles).
Demonstrates initiative and resourcefulness by making recommendation and communicating trends and issues to management.
Crossed trained in other areas within Patient Accounts.
Begin HBI Revenue Cycle classes.
Understands and maintains compliance with HIPAA guidelines when handling patient information.
Performs other duties as assigned.