Patient Account Representative

About the role

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.

Responsibilities

• Post all incoming payments to correct patient accounts on a daily basis
• Input and retrieve data from computer systems
• Reconcile accounts daily
• Apply payments to patient accounts accurately and efficiently
• Distribution of all billing to appropriate personnel
• Review and perform follow-up on all authorizations and specialty referrals
• Maintain a current knowledge of contracts and state Worker's Compensation fee schedules
• Handle incoming and outgoing mail pertaining to the hospital
• Recognize and correct mailing errors immediately
• Exercise proper tact and discretion in handling inquiries from patients and their families
• Analyze payments received from insurance companies to assure maximum and correct reimbursement of Hospital's receivables utilizing complex and varying regulations, guidelines and systems
• Proactively work with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment
• Utilize and apply appropriate California and Federal regulations to assure compliance in payment practices
• Apply contractual adjustments to patient AR balances as needed
• Manage and forward underpayments/denials to the appropriate departments for follow-up and further revenue collection as needed

Qualifications

• Ability to multi-task and prioritize needs to meet required timelines
• Analytical, mathematical and problem-solving skills required
• Customer Services experience required
• Effective written and verbal communication skills
• 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
• High School Graduate or GED Equivalent required (effective 4/1/14 for all new hires)
• Knowledge of basic understanding medical coding and third-party operating procedures and practices
• Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience required
• Medical and Insurance terminology essential

Pay

A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $23.12 to $28.00. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Benefits

Prime Healthcare offers a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.

Schedule

Full Time, Shift Days