Patient Account Specialist
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 3.0million 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! The Patient Account Specialist is responsible for submitting claims to the appropriate intermediaries and to insure that procedures and charges are coded in compliance with all payer guidelines and state/federal regulations, when assigned. Under the supervision of the Director, the Patient Account Specialist is also responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospital’s receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate regulations in order to assure compliance in payment practices. Leads teams in the resolution of unpaid accounts.
Requirements
- Previous Billing Experience within a hospital Business Office Required.
- Previous experience with government programs and collections preferred.
- Knowledge of medical terminology
- Effective written and verbal communication skills
- Ability to multi-task, prioritize needs to meet required timelines
- Analytical and problem-solving skills
- Customer Services experience required
- High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
Responsibilities
- submitting claims to the appropriate intermediaries
- insure that procedures and charges are coded in compliance with all payer guidelines and state/federal regulations, when assigned
- accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received
- analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospital’s receivables
- works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment
- applies the appropriate regulations in order to assure compliance in payment practices
- Leads teams in the resolution of unpaid accounts
Benefits
- paid time off
- a 401K retirement plan
- medical, dental, and vision coverage
- tuition reimbursement
- many more voluntary benefit options
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
