Prime Healthcare

Account Representative

Prime Healthcare  •  Harlingen, TX (Onsite)  •  8 days ago
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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

EDUCATION, EXPERIENCE, TRAINING

  • Ability to multi-task, prioritize needs to meet required timelines
  • Analytical, mathematical and problem-solving skill preferred
  • Customer Services experience preferred
  • 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 preferred
  • 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

    Prime Healthcare

    About Prime Healthcare

    About Prime Healthcare and Prime Healthcare Foundation: Prime Healthcare is an award-winning health system operating 51 hospitals and more than 360 outpatient locations in 14 states, providing over 2.5 million patient visits annually. It is one of the nation's leading health systems, with nearly 57,000 employees and affiliated physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Based in Ontario, California, Prime Healthcare is nationally recognized for award-winning quality care and has been named a 10 Top and 15 Top Health System by Truven Health Analytics. Its hospitals have been named among the nation's "100 Top Hospitals" 69 times and have received more Patient Safety Excellence Awards from Healthgrades than any other health system in the past eight years. To learn more, please visit primehealthcare.com.

    Industry
    Healthcare & Social Services
    Company Size
    5,001-10,000 employees
    Headquarters
    Ontario, California
    Year Founded
    Unknown
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