Patient Account Specialist

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 over 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

• Submit claims to the appropriate intermediaries and ensure procedures and charges are coded in compliance with all payer guidelines and state/federal regulations.
• Analyze payments received from insurance companies to ensure maximum and correct reimbursement of the hospital’s receivables, utilizing complex regulations, guidelines, and systems.
• Proactively work with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment.
• Apply appropriate regulations to ensure compliance in payment practices.
• Lead teams in the resolution of unpaid accounts.
• Perform accurate and timely payment analysis of managed care contracts to determine appropriate reimbursement under the supervision of the Director.

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, and meet required timelines.
• Analytical and problem-solving skills.
• Customer service experience (required).
• High school graduate or GED equivalent (required for all new hires effective 4/1/14).

Pay

A reasonable compensation estimate for this role is $23.70 to $29.00 per hour. The exact starting compensation will be determined based on factors such as skillset, years of applicable experience, education, credentials, and licensure.

Benefits

Prime Healthcare offers a comprehensive benefits package that provides flexibility to tailor benefits according to individual needs. Benefits include, but are not limited to:

• Paid time off.
• 401K retirement plan.
• Medical, dental, and vision coverage.
• Tuition reimbursement.
• Additional voluntary benefit options.

Schedule

• Employment Status: Full Time
• Shift: Days