Senior Patient Account Representative

Patient Account Rep Senior (MEM009839) Location: Fountain Valley Shift: Days/Predominantly Remote (8hr shift) Pay Range: $25.22/hr - $36.57/hr Additional Perks of position: Remote Work/Work from Home Monthly Bonus/Incentive Program Internet/Wireless Expense Reimbursement Position Summary Commercial and Managed MCAL Patient Account Representative, Senior is responsible for all Commercial and Managed MCAL insurance collections of accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible. This position takes ownership of their accounts and eliminates barriers to ensure timely and correct payment including involvement with payors upper management when necessary. The role requires working knowledge of Commercial managed care and Managed MCAL contracts, along with complex payment methodologies to ensure prompt and accurate reimbursement. The position must understand and apply many complex and varying State and Federal statutes, guidelines, and systems, and perform the account follow‑up function with all Commercial payors, Managed MCAL payors, and government agencies to obtain maximum and correct reimbursement of accounts receivables. It proactively works with all payors and internal resources to identify and resolve issues that hinder account payment. Applies independent judgment, research, and knowledge to audit Commercial and Managed MCAL payor payments, denials, appeals, and billing issues. This position offers the opportunity to work from home (WFH) after all training has been completed. Once completed the employee will need to be available to come into the office for additional training, meetings, etc., as needed. Essential Functions and Responsibilities of the Job Provide prompt and courteous customer service to all internal and external customers. Use critical thinking to research, review, and follow‑up on all accounts. Communicate effectively in verbal and written form. Analyze documentation and resolve patient, billing and/or collection issues appropriately and timely. Work independently with minimal supervision. Identify and analyze problems in a timely manner and independently initiate appropriate actions to resolve problems or issues. Be punctual, follow organization rules and procedures, and adhere to directions from a Coordinator/Lead or other member of the Management staff. Adhere to all confidentiality policies and procedures, carrying out tasks in a pleasant and respectful manner. Make suggestions for enhancements throughout the department and continually seek opportunities to improve current policies, procedures, and practices. Recognize and perform essential duties and help others or perform other required tasks when own assignments are completed; performs other duties as assigned by management. Use critical thinking while reviewing billing and collection notes in the financial computer system to ensure that the appropriate action is taken within the billing and collection process and to ensure correct hospital reimbursement. Maintain punctuality at work. Follow company policies, procedures, and directives. Interact in a positive and constructive manner. Prioritize and multitask. Qualifications Experience Minimum 1 year hospital business office experience (required). Acute Care Hospital Collections experience (required). Understanding of managed care (PPO, HMO, Medicare Advantage and Managed Medi-Cal) insurance collection processes including denial resolution and appeals (required). Excellent interpersonal skills. Positive work ethics. Knowledge of medical terminology and coding. Written and verbal communication skills to meet productivity standards. Microsoft Office and Outlook experience. Education Business‑related courses preferred. AA Degree or medical field certificate, preferred. Benefits (inapplicable text removed) MemorialCare offers high quality health insurance plan options, allowing employees to select the best choice for their family. #J-18808-Ljbffr