Patient Account Specialist

Prime Healthcare; Ontario; On-site; CAD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is looking for a Patient Account Specialist to ensure compliance with payer guidelines and analyze payments to maximize reimbursement. This role is critical for effective healthcare operations and requires strong analytical, communication, and billing skills. The position offers competitive compensation and a comprehensive benefits package.

Benefits

401K retirement plan

Paid time off

Medical, dental, and vision coverage

Tuition reimbursement

Qualifications

• Previous Billing Experience within a hospital Business Office Required.
• Knowledge of medical terminology.
• Ability to multi-task and prioritize needs to meet required timelines.

Responsibilities

• Responsible for submitting claims to appropriate intermediaries.
• Conduct accurate and timely payment analysis of managed care contracts.
• Proactively work with payers to resolve issues hindering account payments.

Skills

Analytical and problem-solving skills

Effective written and verbal communication skills

Knowledge of medical terminology

Ability to multi-task, prioritize needs

Education

High School Graduate or GED Equivalent

Job description

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nation’s leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories.

Responsibilities

The Patient Account Specialist is responsible for submitting claims to the appropriate intermediaries and to ensure that procedures and charges are coded in compliance with all payer guidelines and state / federal regulations, when assigned. Under the supervision of the Director, the Patient Account Specialist is also responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospital’s receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate regulations in order to assure compliance in payment practices. Leads teams in the resolution of unpaid accounts.

Qualifications

• Previous Billing Experience within a hospital Business Office Required.
• Previous experience with government programs and collections preferred.
• Knowledge of medical terminology
• Effective written and verbal communication skills
• Ability to multi-task, prioritize needs to meet required timelines
• Analytical and problem-solving skills
• High School Graduate or GED Equivalent Required (effective 4 / 1 / 14 for all new hires)

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $21.00 to $22.00. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.