Account Representative - PHMI Harlingen CBO in Harlingen, TX at Prime Healthcare

Date Posted: 2/4/2020

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    2420 East Tyler Avenue
    Harlingen, TX
  • Job Type:
  • Experience:
    At least 1 year(s)
  • Date Posted:
    2/4/2020

Job Description


Responsibilities

The Account Representative is responsible for posting all incoming payments to correct patient accounts on a daily basis. Inputs and retrieves data from computer systems. Reconciles accounts daily. Applies payments to patient accounts accurately and efficiently. Distribution of all billing to appropriate personnel. Reviews and performs follow-up on all authorizations, and specialty referrals. Maintains a current knowledge of contracts and state Worker's Compensation fee schedules. Responsible for the handling of incoming and outgoing mail pertaining to the hospital. Needs to have ability to recognize and correct mailing errors immediately. Always uses proper tact and discretion in handling inquiries from patients and their families. The Account Representative is responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospital's receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate California and Federal regulations in order to assure compliance in payment practices. Responsible for posting all incoming payments to correct patient accounts on a daily basis. Inputs and retrieves data from computer systems. Reconciles accounts daily. Applies payments to patient accounts accurately and efficiently. Applies contractual adjustments to patient AR balances as needed. Manage and forward underpayments /denials to the appropriate departments for follow-up and further revenue collection as needed.

Qualifications

Education and Work Experience
  • Ability to multi-task, prioritize needs to meet required timelines.
  • Analytical, mathematical and problem-solving skills required.
  • Customer Services experience required.
  • Effective written and verbal communication skills.
  • Experience in accounts payable, accounts receivable or cashier experience preferred.
  • Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred.
  • High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires).
  • Knowledge of basic understanding medical coding and third-party operating procedures and practices.
  • Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience required.
  • Medical and Insurance terminology essential
    We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf