Patient Account Rep

Scotland Memorial Hospital•Laurinburg, NC

11d•Onsite

About The Position

Scotland Health Care System is seeking a dedicated Patient Account Representative to join their Patient Financial Services team. This full-time position is based in Laurinburg, North Carolina, and operates on a Monday-Friday, 8 AM to 5 PM schedule. The role involves examining denied and underpaid claims, communicating with payers, analyzing denial reasons, and working with management to identify and address root causes of denials to reduce Accounts Receivable. The representative will maintain up-to-date payer information, handle communications with payers and internal departments, and participate in continuous quality improvement efforts. A thorough understanding of federal and state regulations, payer requirements, and HIPAA guidelines is essential. The position also includes cross-training in other Patient Accounts areas and participation in HBI Revenue Cycle classes. Scotland Health Care System is a community-owned, not-for-profit organization founded in 1946, committed to delivering safe, high-quality, compassionate, and sustainable healthcare.

Requirements

Thorough knowledge and understanding 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.
Ability to update and maintain accurate files on each payer.
Ability to thoroughly document all interactions with payers.
Effective communication skills (telephone and email).
Understanding and maintenance of compliance with HIPAA guidelines when handling patient information.

Nice To Haves

Crossed trained in other areas within Patient Accounts.
Begin HBI Revenue Cycle classes.

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.