Patient Account Representative

Prime Healthcare•Lynwood, CA

3d•Onsite

About The Position

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0 million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one 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, prioritize needs to meet required timelines
Analytical, mathematical and problem-solving skills required
Customer Services experience required
Effective written and verbal communication skills
High School Graduate or GED Equivalent Required
Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience required
Medical and Insurance terminology essential

Nice To Haves

Experience in accounts payable, accounts receivable or cashier experience preferred
Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred
Knowledge of basic understanding medical coding and third-party operating procedures and practices

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.
Distribution of 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 of 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.
Accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received.
Analyzing payments received from insurance companies to assure maximum and correct reimbursement of Hospital’s receivables, utilizing many complex and varying regulations, guidelines and systems.
Proactively working with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment.
Utilizing and applying the appropriate California and Federal regulations in order 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.