PFS Follow Up Representative, FT, Days

Prisma Health•Greenville, SC

2d•Remote

About The Position

Inspire health. Serve with compassion. Be the difference. Job Summary Posts payments and adjustments to invoices resolving any outstanding accounts according to departmental and regulatory guidelines. This is a remote position Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Analyses and reviews prior account activity and takes necessary actions including calling payer or utilizing payer websites for current status of outstanding accounts receivable (AR). Takes necessary actions to correct claim or obtain any requested information to the payer. Utilizes all appropriate workflows and completes appropriate and detail notes on every account preparing for next steps and/or resolution. Performs daily duties related to collections, variances and/or technical denials in a manner that constantly drives the account towards resolution, while challenging unacceptable responses from payers. Understands, interprets and applies managed care contract terms to accounts for payer resolution. Escalates accounts when appropriate, including but not limited with payer, internally and/or patient when appropriate in accordance with the Prisma Health escalation guidelines in order to minimize aging. Identifies trends and repeated problems and/or charge corrections to management. Contributes to PFS department matrix. Utilizes time and resources, assisting co-workers as time allows. Productivity and quality of work must be met. Identifies areas for improvements. Monitors quality levels, identifies root cause of quality problems and owns/acts on quality problems. Performs other duties as assigned.

Requirements

High School diploma or equivalent OR post-high school diploma/highest degree earned
Two (2) years medical billing, customer service, follow up and/or medical office experience.
Communication skills
Understands, promotes and adheres to all matters of compliance with laws and regulations.
Maintains professional growth and development through seminars, workshops, in-service meetings, current literature and professional affiliations to keep abreast of latest trends in field of expertise.
Medical billing, follow up and/or medical office skills
Analytical skills
Attention to detail

Nice To Haves

CRCA preferred.
CRCR preferred.

Responsibilities

Posts payments and adjustments to invoices resolving any outstanding accounts according to departmental and regulatory guidelines.
Analyses and reviews prior account activity and takes necessary actions including calling payer or utilizing payer websites for current status of outstanding accounts receivable (AR).
Takes necessary actions to correct claim or obtain any requested information to the payer.
Utilizes all appropriate workflows and completes appropriate and detail notes on every account preparing for next steps and/or resolution.
Performs daily duties related to collections, variances and/or technical denials in a manner that constantly drives the account towards resolution, while challenging unacceptable responses from payers.
Understands, interprets and applies managed care contract terms to accounts for payer resolution.
Escalates accounts when appropriate, including but not limited with payer, internally and/or patient when appropriate in accordance with the Prisma Health escalation guidelines in order to minimize aging.
Identifies trends and repeated problems and/or charge corrections to management.
Contributes to PFS department matrix.
Utilizes time and resources, assisting co-workers as time allows.
Identifies areas for improvements.
Monitors quality levels, identifies root cause of quality problems and owns/acts on quality problems.
Performs other duties as assigned.