PFS A/R Rep

St. Tammany Parish Hospital • Vandergrift, PA

7d

About The Position

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine beauty of St. Tammany Parish adds to our attractive compensation package. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain. It is a peaceful, scenic, community-oriented area with an abundance of amenities to suit every taste. JOB DESCRIPTION AND POSITION REQUIREMENTS Scheduled Weekly Hours: 40 WORK SHIFT: (M-F) 8am - 4:30pm JOB SUMMARY: Responsible for all duties involved with the follow-up and prompt collections of inpatient and outpatient account balances; ensures that claims are adjudicated timely and appropriately for payment or denial by payers. Time frames are specific and must be adhered to so that reimbursement is received timely. Responsible for telephoning patients and/or insurance companies to resolve account balances.

Requirements

• High school diploma or equivalent
• Proficient computer skills, as well as all office equipment
• Ability to efficiently and effectively work with insurance companies, patients/patient representatives, and other STHS Departments
• Strong analytical and problem-solving skills
• Familiar with payment methodologies including fee schedules, per diems, case rates, case mix and carve outs
• Possess knowledge of current billing guidelines and can research via resources such as CMS website, MLN, LMRPs, payor websites, CCI editor, MUE editor
• Resolve both denial and discrepancy issues in claim payments by insurance payers
• Ability to communicate effectively and professionally, both verbally and in writing
• Use Microsoft Office in performance of duties and responsibilities
• Must possess good physical health
• Some requirements include but are not limited to standing, sitting or walking for long periods of time.
• Lifting at least 20 pounds is required

Nice To Haves

• 1 year insurance collections/follow-up experience preferred in a medical clinic, hospital facility, revenue cycle, registration, financial counseling, or other healthcare entity.
• Use of EPIC and/or nThrive billing systems.

Responsibilities

• Responsible for all duties involved with the follow-up and prompt collections of inpatient and outpatient account balances
• Ensures that claims are adjudicated timely and appropriately for payment or denial by payers
• Responsible for telephoning patients and/or insurance companies to resolve account balances

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED