Patient Account Representative

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

8d•Onsite

About The Position

Scotland Health Care System is seeking an additional associate for the Patient Financial Services department. This role involves examining denied and underpaid claims to determine reasons for discrepancies, providing payers with specific reasons for suspected underpayments, and analyzing denial reasons given by payers. The position works with management to identify, trend, and address root causes of denials, and helps pinpoint strategies for reducing Accounts Receivable (AR). The representative will maintain a thorough knowledge of federal and state regulations, payer requirements, and explanation of benefits to identify and report billing compliance issues and payer discrepancies. They will also update and maintain accurate files on each payer, document all interactions with payers, and handle communication from payers and departments within Revenue Cycle. The role includes participating in continuous quality improvement efforts, demonstrating initiative by making recommendations and communicating trends to management, and being cross-trained in other areas within Patient Accounts. The position requires understanding and maintaining compliance with HIPAA guidelines when handling patient information and performing other duties as assigned. The Scotland Health Care System is a community-owned, not-for-profit organization founded in 1946, dedicated to delivering safe, high-quality, compassionate, and sustainable healthcare.

Requirements

Understanding and maintaining compliance with HIPAA guidelines when handling patient information

Nice To Haves

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