Patient Account Representative

4 days ago

Pinehurst, North Carolina, United States SCA Health Full time
Patient Account Representative Opportunity

We are seeking a highly skilled Patient Account Representative to join our team at SCA Health. As a Patient Account Representative, you will play a critical role in ensuring accurate and timely patient account follow-up with insurances to ensure accurate accounts receivable reporting.

Key Responsibilities:

  • Primary functions are credit balance management, patient balance resolution, and non-patient (insurance) resolution.
  • Accurate and timely follow-up and resolution for all accounts receivable.
  • Meeting and maintaining cash collection metrics and goals.
  • Maximized facility reimbursement.
  • Understands each payer contract and will utilize to ensure payments received are correct.
  • Understands and can explain the Explanation of Benefits received from any payer.
  • Works closely with payer provider relations representatives.
  • Has thorough knowledge of ASC Allowable procedures.
  • Handles contracted and non-contracted; HMO, PPO, EPO, POS, Worker's Com., self-pay, and third-party reimbursement issues.
  • Effectively and independently handles second-level reimbursement issues, contracted and non-contracted denials for serviced before and after procedures.
  • Works all denials and corrected claims collaborating with the biller and/or Business Office Manager, insurance payers, and/or patients on past due accounts.
  • Follow center policies, procedures, and best practices for resolution and reassignment of accounts.
  • Possess basic knowledge of medical terminology and health insurance billing.
  • Have ability to communicate effectively with patients, physicians, and other teammates.

Requirements:

  • Associate's Degree or equivalent from a two-year College or technical school; and two years' experience in a medical office as a patient account representative.
  • Candidate MUST HAVE knowledge of medical billing, payer follow-up, payer contracts, appeals, self-pay billing, Medicare and Medicaid billing, AR posting, along with excellent customer service skills.
  • Experience in a hospital, outpatient surgery center, or related field is a MUST; Computer experience, Excel, Word, Medical Billing Software, and Applications; Working knowledge of Medical Terminology.

Compensation:

USD $16.00/Hr. USD $19.00/Hr.

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