Job Description

We are seeking an Account Representative, sometimes referred to as a Patient Financial Services Representative, or Patient Account Services Representative. The Account Representative is responsible for accurately posting and reconciling daily payments, applying contractual adjustments, and ensuring patient accounts reflect correct and timely reimbursement. The Account Representative analyzes insurance payments for compliance with managed care contracts and state and federal regulations, resolves underpayments or denials, distributes billing and correspondence appropriately, and provides professional support to patients and internal departments.

Shifts Available: Days

Employment Type: Full-time

Hours: 8-hour shifts

Location: Harlingen Central Billing Office – Harlingen, TX

Here are some of the benefits of working at Prime Healthcare:

• Health, dental, and vision insurance options
• Paid vacation, sick time and holidays
• Bereavement leave, FMLA and other leave options
• Employer 401K options
• Tuition reimbursement options
• Life, disability, and other insurance options
• Many other amazing benefits

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/

Responsibilities

Essential Duties and Responsibilities (includes, but not limited to):

• Accurately post and reconcile daily incoming payments, apply contractual adjustments, and maintain correct patient account balances within hospital systems
• Analyze insurance payments and managed care contracts to ensure accurate reimbursement and compliance with state and federal regulations, including Worker’s Compensation fee schedules
• Identify, investigate, and escalate underpayments or denials while collaborating with payers and internal departments to optimize revenue collection
• Distribute billing appropriately, manage hospital-related incoming and outgoing mail, and promptly correct mailing discrepancies
• Provide professional, tactful communication when assisting patients, families, and internal stakeholders regarding account inquiries and payment matters

Qualifications

Before we go any further, we do have some deal-breakers. You must have:

EDUCATION, EXPERIENCE, TRAINING

1. Ability to multi-task, prioritize needs to meet required timelines2. Analytical, mathematical and problem-solving skill preferred3. Customer Services experience preferred4. Effective written and verbal communication skills5. Experience in accounts payable, accounts receivable or cashier experience preferred 6. Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred7. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)8. Knowledge of basic understanding medical coding and third-party operating procedures and practices9. Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience preferred10. Medical and Insurance terminology essential

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

#LI-JC5