Patient Account Representative Specialist- Underpayment Recovery, Full-Time job, Days, Albuquerque, NM
We are looking for a Patient Account Representative Specialist to join our Underpayment team in Albuquerque, NM.
This full-time job is located with Lovelace Shared Services, organizational support departments for all Lovelace facilities including Coding, Finance, Health Information Management, Revenue Cycle, Marketing, and the Resource Team. We are dedicated to exceeding our customers' expectations in every way.
Patient Account Representative Specialist Job Responsibilities:
- Ability to prioritize and complete follow up and collection of payment for Non Govt claims in accordance with departmental policies and procedures with little to no supervision.
- Responsible for successful claim payment within established accounts receivable key performance indicators. Manage and reconciles accounts, update and document financial data, utilize excellent customer service skills to contact patients and insurance carriers to ensure accurate reimbursement in accordance with current payor contracts.
- Utilize current technology, which may include web based products such as EPIC, SSI, Nthrive, RAC tracker, E.H.R., RTE, and payer portals.
- Identify and resolve issues associated with claim underpayment.
- Contact designated insurance carriers to inquire on underpayment.
- Review Managed Care Contracts and compare against claims to identify discrepancies.
- Maintains payer spreadsheets and joins payer calls and JOCs meetings.
- Works a minimum of 36 accounts per day identified as underpayments.
- Negotiates with non-contracted payers to collect on accounts prior to making self-pay.
- Identifies accounts as recovered and follows up as needed or closes.
Patient Account Representative Specialist Education and Experience Job Requirements:
- High School Diploma or GED, Associate's Degree in Business or related field desired
- Three (3) years of job-related experience preferably in in a Healthcare business environment.
- HFMA Certified Revenue Cycle Representative (CRCR) desired
- Knowledge of medical terminology and billing/collections practices; knowledge of payer edits, rejections, rules and how to appropriately respond to each
- Accuracy in identifying the cause of rejections/denials and selecting the most appropriate method for resolution
- Needs to have knowledge of assigned payer contracts, processes and issues.
- Demonstrates proficiency with timely and successful appeals to insurance companies
- Ability to demonstrate initiative, and time management skills
- Excellent analytical skills and problem-solving skills
- Multi task in a fast paced environment and handle overlapping commitments and deadlines
- Named one of the 150 Great Places to Work in Healthcare by Becker's Hospital Review
- Named one of the Best Places to Work by Albuquerque Business First
- Named Top Workplace by Albuquerque Journal, 2013, 2014, and 2015
- Named to Modern Healthcare's 100 Best Places to Work five times since 2008
Lovelace is a drug-free employer with smoke free campuses.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.