The Commercial Patient Account Representative, Lead, is responsible for assisting staff with the commercial billing and/or collection of accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible.
Duties & Responsibilities:
This position will have working knowledge and understanding of managed care contracts including other complex payment methodologies to ensure prompt and accurate reimbursement.
This position must be able to utilize and understand many complex and varying State and Federal statutes and regulations, guidelines and systems, and perform the account follow-up function with all Commercial payors and government agencies to obtain maximum and correct reimbursement of accounts receivables.
This position proactively interacts with insurance companies, government agencies and/or patients to obtain maximum and correct reimbursement of accounts receivable. I
This position works with all payors and internal resources to identify and resolve issues that hinder account payment.
Applies independent judgment, research and knowledge to audit payor payments, denials, appeals and billing issues.
Assists with department workload and provides support to staff, as directed.
Supports Management with day-to-day operations and works closely with the department Coordinator to ensure a high level of performance with a commitment to continuous improvement
Experience & Qualifications:
Minimum 4 years’ experience and understanding of commercial hospital billing and collections processes, required
Excellent interpersonal skills
Understand and follow oral and written instructions
Positive work ethics
Knowledge of medical terminology and coding, preferred
Written and verbal communication skills to meet productivity standards
Use of 10-key calculator by touch preferred
Microsoft Office and Outlook experience
High School diploma, GED equivalent, preferred
Business related courses, preferred
AA Degree or medical field certificate, preferred
Internal Number: MEM003417
Let us introduce ourselves. We're MemorialCare, a nonprofit health system that includes four hospitals, two medical groups, imaging centers, surgical centers and much more. As one of the leading health systems in Orange County and Los Angeles County, we're confident that no matter what your needs are, we have the teams, tools and know-how to support you every step of the way.