Account Specialist

2 weeks ago

Orange, United States Prospect Medical Holdings Full time
Job Description

The Account Specialist is responsible for the collection of outstanding patient accounts from various insurance companies. Overcomes barriers to assure timely and correct payment. Understands managed care contracts to ensure prompt and accurate reimbursement.

Responsibilities

  • Conducts appropriate account activity on final billed claims by contacting government agencies, commercial insurance payers, third party payers, and patients/guardians via phone, email or on-line. Ensures that issues with accounts are clearly articulated, and completes the correct steps to get the account corrected, paid, and closed.
  • Ensures daily productivity standards of assigned accounts are met. Maintains inventory with no back-log. Prioritizes assigned tasks and conducts the appropriate follow through. Responds effectively to questions regarding collection accounts and provides an accurate explanation of status.
  • Reviews contracts and ensures that accounts are adjusted and/or paid correctly. When appropriate, requests re-bills, secondary billing, corrected billing and/or adjustment to accounts. Ensures identified issues are properly documented in notes.
  • Recognizes potential delays with payor so that corrective actions can be taken. Obtains information, as needed, from appropriate internal sources. Responds in a timely manner to avoid AR aging. Submits accurate and timely written technical appeals, as needed. Escalates payment delays/problem accounts to supervisor in a timely manner.
Qualifications

Required Qualifications:
  • High School Diploma or GED
  • Understanding of Managed Care Payer Contracts and contract language
  • Excellent written and verbal communication skills in English
  • Ability to multitask and maintain a work pace appropriate to workload
  • Computer literacy and proficiency
  • Must demonstrate customer service skills appropriate to the job
Preferred Qualifications:
  • Minimum of 2 years billing and collecting experience in an automated environment
  • Previous Healthcare Experience

Pay Rate: Min - $21.00 | Max - $27.35

About Us

Prospect Medical Holdings' ability to deliver quality, compassionate care during the unprecedented pandemic affirms the original vision of its founders. This is the fulfillment of the hopes Prospect's founders had for the company, and proof that a clear vision, an insightful operating model, and a commitment to communities and our employees, born in the past, remains the way of the future.

Every day, our more than 11,000 affiliated physicians and 18,000 employees at 17 hospitals, 165 outpatient centers and 28 medical groups provide nationally recognized care in six states. Our comprehensive network of quality healthcare services is designed to offer our patients and 600,000 members highly coordinated, personalized care tailored to the unique needs of each community we serve-many of which provide essential medical services to underserved communities as safety-net hospitals.

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