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Patient Account Representative

Wellington Regional Medical Center

Insurance Claims Processor

This position is responsible for processing insurance claims for assigned facilities in a timely manner. This position ensures review and collecting of payments from insurance agencies and patients for the assigned facilities. This position requires collaboration between the insurance agencies, the facility, and the patient in resolving any problems that may occur during each Revenue Cycle.

Essential Duties and Responsibilities:

  • Processes the filing for all assigned claims.
  • Ensures requirements are met and claims are followed-up on daily to eliminate denials and non-payment of claims.
  • Reviews and conducts research on insurance correspondence and makes necessary corrections to ensure appropriate claims payment.
  • Conducts research and follow-up on denials in a timely manner and proactively communicates any denial issues related to billing requirements.
  • Completes re-bill request as necessary to facilitate timely and proper claims payment.
  • Contact and explain insurance benefits and collect payments to patients.
  • Resolve any issues related to the patient accounts and negotiate any overdue balance to recover payments form patients.
  • Assist patients with terms for payment plans when necessary.
  • Monitors contracts and single patient agreements to ensure appropriate reimbursement is received.
  • Reviews each eligibility of benefits (EOB) for proper reimbursement and answer inquiries and correspondence from patients and insurance companies to facilitate payment.
  • Manages assigned projects related to obtaining appropriate and timely reimbursement of outstanding claims and performs various collection actions including contacting third party payers or patients by phone

* Sign on Bonus: Apply today and earn a $1,500 sign on bonus after meeting employment requirements. This opportunity provides the following: Challenging and rewarding work environment, Growth and development opportunities within UHS and its subsidiaries, Competitive Compensation, Excellent Medical, Dental, Vision and Prescription Drug Plan. 401k plan with company match, Generous Paid Time Off

About Universal Health Services: One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $14.3 billion in 2023. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 96,700 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Qualifications Requirements:

  • High School Graduate/GED Required
  • Vocational Technical School Graduate preferred
  • 1-3 Years Related work experience required
  • Understands billing requirements for commercial payers and Medicaid.
  • Demonstrates understanding of both UB04 claim form, CMS 1500 claim form, and Explanation of Benefits.
  • Understands which insurance require which type of claim form.
  • Knowledge of basic medical coding and third-party operating procedures and practices
  • Demonstrates ability to work effectively with and interact with patients and co-workers in a professional, courteous manner that adheres to FRN's Mission and Statement of Values
  • Read and Understand an Explanation of Benefits Remittance Advice
  • Average Skill level with Microsoft, Excel, Word.

EEO Statement: All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Vacancy posted 5 days ago
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