Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan, and a growing multi-specialty medical group. Founded in New Mexico in 1908. Largest private employer in the state with nearly 14,000 employees, including more than 1600 providers and nearly 4,700 nurses. Health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care), and Commercial health plans.

Patient Accounting Collections Specialist I-ABQ

Full TimeRemoteTeam 10,001

Location

United States

Posted

6 days ago

Salary

Not specified

No structured requirement data.

Job Description

This role involves following up, collecting, and resolving all outstanding accounts receivable. Performs a variety of duties including accounts receivable follow-up, customer service, correspondence response, and daily reconciliation of activities. Performs accounts receivable follow-up activities for assigned work queues and/or miscellaneous A/R reports. Responsible for contacting insurance companies, patients, and employers regarding outstanding claims. Provides any information (medical records, itemized statements, etc.) requested by insurance companies to process claims. Maintains a system to ensure timely follow-up is completed for each outstanding claim. Identifies and reports insurance payor issues to lead, providing all pertinent information including examples, correspondence, EOBs, claims, etc. Consults with lead regarding next steps with difficult claims. Communicates all issues to teammates and Follow-up & Collection Supervisor. Refers accounts, in accordance with PHS guidelines, to leadership for adjustment, agency placement, or attorney referral. Cross trains in various Patient Accounting Department areas to be familiar with all aspects of patient accounting functions as they relate to collections. Performs other duties as assigned by the Follow-up & Collection Supervisor and/or Manager. Documents accounts in accordance with established PHS policies and procedures. Effectively operates and is familiar with various computer systems, including Epic, FinThrive, FISS/DDE, Presbyterian Health Plan Provider Portal, Payer portals, Microsoft Office Suite. Must be an effective team member with great communication skills. Participates in team meetings and communicates work-related ideas and concerns proactively. Develops and maintains positive working relationships with team members and all PHS departments. Ensures that goals and objectives are met in conformity with PHS policies and procedures and CMS compliance rules and regulations. Maintains strictest confidentiality, adheres to all HIPAA guidelines/regulations.

Job Requirements

  • High School diploma or GED required.
  • Less than 1-year healthcare clerical or customer service experience preferred.
  • Passionate about contributing to an organization focused on continuously improving patient experiences and the health of the community.
  • Experience with Microsoft Office Suite products preferred.
  • Excellent organizational, problem-solving, verbal and written communication skills.
  • Attention to detail and ability to interact effectively with other functional areas and management teams are required.
  • Strong work ethic and demonstrated ability to work effectively in a team environment.
  • Able to prioritize and manage a high-volume workload.
  • Able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.
  • Basic knowledge of ICD-10, HCPCS, CPT codes, Revenue Codes, UB04 and HCFA 1500 claim forms, and understanding of electronic processing of 837 and 835 is preferred.
  • Basic knowledge of Coordination of benefits and the Medicare MSPQ preferred.
  • Basic knowledge of various payer requirements, claim submission processes for major insurance carriers and intermediaries.
  • Basic knowledge of the revenue cycle processes.
  • Able to provide a high-speed DSL or cable modem for a home office with a minimum standard speed of 25x10 (25mpbs download x 10mpbs upload) required.
  • Able to provide a confidential workspace that is HIPAA compliant and free from distractions.

Benefits

  • Comprehensive benefits package including medical, dental, vision, short-term and long-term disability, group term life insurance, and other optional voluntary benefits.
  • Employee Wellness rewards program designed to provide engaging opportunities to enhance health and activate well-being.

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