Account Representative

Saint Mary's Health Network; Harlingen (TX); On-site; USD 36,000 - 54,000; Full time

Benefits offered by this job

Health, dental, Vision insurance

Paid time off

Holidays

Bereavement leave

401K plan

Tuition reimbursement

Life and disability insurance

Job summary

Saint Mary's Health Network in Harlingen, TX is seeking a full-time billing specialist to post and reconcile payments, analyze insurance remittances, and resolve denials. You will support patient accounts and collaborate with hospital teams to ensure accurate, timely revenue cycles.

The role requires strong numerical skills, attention to detail, and knowledge of billing procedures and insurance terminology. Day shifts, with full benefits and an opportunity to grow within Prime Healthcare network.

Qualifications

• Ability to multi-task and prioritize to meet timelines
• Analytical, mathematical and problem-solving skills
• Customer service experience preferred
• Effective written and verbal communication skills
• Experience in accounts payable, accounts receivable or cashier experience preferred
• Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred
• High School Graduate or GED Required
• Knowledge of basic understanding medical coding and third-party operating procedures and practices
• Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience preferred
• Medical and Insurance terminology essential

Responsibilities

• Accurately post and reconcile daily payments, apply contractual adjustments, and maintain correct patient account balances within hospital systems
• Analyze insurance payments and managed care contracts to ensure accurate reimbursement and compliance with state and federal regulations, including Workers Compensation fee schedules
• Identify, investigate, and elevate underpayments or denials while collaborating with payers and internal departments to optimize revenue collection
• Distribute billing appropriately, manage hospital-related incoming and outgoing mail, and promptly correct mailing discrepancies
• Provide professional, tactful communication when assisting patients, families, and internal stakeholders regarding account inquiries and payment matters

Skills

Multi-tasking

Analytical skills

Customer service

Written and verbal communication

Accounts receivable

Medical terminology

Medical coding knowledge

Billing regulations knowledge

Education

High School Diploma or GED

Job description

Overview

Shifts Available: Days

Employment Type: Full-time

Hours: 8-hour shifts

Location: Harlingen Central Billing Office - Harlingen, TX

Responsibilities

• Accurately post and reconcile daily incoming payments, apply contractual adjustments, and maintain correct patient account balances within hospital systems
• Analyze insurance payments and managed care contracts to ensure accurate reimbursement and compliance with state and federal regulations, including Workers Compensation fee schedules
• Identify, investigate, and elevate underpayments or denials while collaborating with payers and internal departments to optimize revenue collection
• Distribute billing appropriately, manage hospital-related incoming and outgoing mail, and promptly correct mailing discrepancies
• Provide professional, tactful communication when assisting patients, families, and internal stakeholders regarding account inquiries and payment matters

Qualifications

1. Ability to multi-task, prioritize needs to meet required timelines2. Analytical, mathematical and problem-solving skill preferred3. Customer Services experience preferred4. Effective written and verbal communication skills5. Experience in accounts payable, accounts receivable or cashier experience preferred 6. Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred7. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)8. Knowledge of basic understanding medical coding and third-party operating procedures and practices9. Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience preferred10. Medical and Insurance terminology essential

Pay Transparency

• Health, dental, and vision insurance options
• Paid vacation, sick time and holidays
• Bereavement leave, FMLA and other leave options
• Employer 401K options
• Tuition reimbursement options
• Life, disability, and other insurance options
• Many other amazing benefits

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

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. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

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