Patient Account Representative - Treasure Valley Hospital

Patient Account Representative

Overview At SCA Health, we believe health care is about people the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization. As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy. What sets SCA Health apart isn't just what we do, it's how we do it. Each decision we make is rooted in seven core values : clinical quality, integrity, service excellence, teamwork, accountability, continuous improvement and inclusion. Our values aren't empty words they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you'll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America. At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more.

Responsibilities The Patient Account Representative will be responsible for thorough and timely patient account follow up with insurances to ensure accurate accounts receivable reporting; to ensure payments by primary and secondary payers and / or self-pay patients are accurate. The PAR will be responsible for daily generation of patient statements. The PAR will be responsible for answering patient calls and correspondence while providing timely, accurate, professional responses and resolution. The PAR will function within the Center's policies and procedures, support SCA Values, SCA Vision and SCA Mission.

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 patient, physicians, and other teammates.

Qualifications : 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. USD $18.00 / Hr. USD $22.00 / Hr.