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St. Tammany Health System · 2 days ago

PFS A/R Rep

Madisonville, LA

Full-time

Onsite

Entry Level

1+ years exp

St. Tammany Health System is dedicated to delivering world-class healthcare in a community-oriented area. They are seeking a PFS A/R Rep responsible for the follow-up and prompt collections of inpatient and outpatient account balances, ensuring timely adjudication of claims for payment or denial by payers.

CommunitiesHealth CareHealth DiagnosticsHospitalWellness

Responsibilities

Responsible for all duties involved with the follow-up and prompt collections of inpatient and outpatient account balances; ensures that claims are adjudicated timely and appropriately for payment or denial by payers

Time frames are specific and must be adhered to so that reimbursement is received timely

Responsible for telephoning patients and/or insurance companies to resolve account balances

Qualification

Insurance collections experienceBilling guidelines knowledgeMicrosoft OfficeAnalytical skillsProficient computer skillsEPIC billing systemNThrive billing systemCommunication skillsProblem-solving skills

Required

High school diploma or equivalent

Proficient computer skills, as well as all office equipment

Ability to efficiently and effectively work with insurance companies, patients/patient representatives, and other STHS Departments

Strong analytical and problem-solving skills

Familiar with payment methodologies including fee schedules, per diems, case rates, case mix and carve outs

Possess knowledge of current billing guidelines and can research via resources such as CMS website, MLN, LMRPs, payor websites, CCI editor, MUE editor

Resolve both denial and discrepancy issues in claim payments by insurance payers

Ability to communicate effectively and professionally, both verbally and in writing

Use Microsoft Office in performance of duties and responsibilities

Preferred

1 year insurance collections/follow-up experience preferred in a medical clinic, hospital facility, revenue cycle, registration, financial counseling, or other healthcare entity

Use of EPIC and/or nThrive billing systems