Patient Account Rep

Scotlandhealth; Laurinburg (NC); On-site; USD 42,000 - 54,000; Full time

Job summary

Scotland Memorial Hospital is seeking a Patient Account Representative to join the Patient Financial Services team. Primary duties include reviewing denied and underpaid claims, communicating with payers, and analyzing denial trends to improve AR performance.

Responsibilities involve maintaining payer contact information, ensuring HIPAA compliance, and supporting quality improvement initiatives. The role requires collaboration with internal departments and participation in training programs as

Qualifications

• Examine denied and underpaid claims to determine discrepancies.
• Provide payers with reasons for suspected underpayments and analyze denial reasons.
• Identify root causes of denials and propose reduction strategies.
• Maintain up-to-date payer contact information.
• Ensure HIPAA compliance in handling patient information.
• Participate in continuous quality improvement initiatives.
• Cross-train in other Patient Accounts areas and attend training.
• Communicate with payers and internal departments via phone and email.

Responsibilities

• Examine denied/underpaid claims to identify discrepancies.
• Explain payer denials with specific reasons to payers.
• Analyze payer denial patterns with management to reduce AR.
• Maintain accurate payer files with contacts and websites.
• Handle payer and department communications by phone and email.
• Support continuous quality improvement by attending huddles and tracking progress.
• Cross-train in other Patient Accounts areas.
• Follow HIPAA guidelines while handling patient data.

Skills

Denied claims

Underpaid claims

Payer communication

Root cause analysis

HIPAA compliance

Quality improvement

Team collaboration

Job description

## Patient Account RepApplylocations: Scotland Memorial Hospital - 500 Lauchwood Dr, Laurinburg, NCtime type: Full timeposted on: Posted Todayjob requisition id: R261579**Department:**Scotland Memorial Hospital - Patient Financial Services**Status:**Full time**Shift:**1st (United States of America)**Schedule Details/Additional Information:**M-F 8-5**Job Description:**1.Examines denied and underpaid claims to determine reasons for discrepancies2.Provide payers with specific reasons for the suspected underpayments and analyzes denial reasons given by payers3.Works with management to identify, trend and address root causes of denials; helps pinpoint strategies for reducing AR.4.Maintains a thorough knowledge and understanding of federal and state regulations, as well as specific payer requirements and explanation of benefits, in order to identify and report billing compliance issues and payer discrepancies5.Updates and maintains accurate files on each payer including contact names, addresses, phone numbers, web sites and other pertinent information thoroughly documents all interactions with payers6.Effectively handles all communication, including telephone and email from payers and departments within Revenue Cycle7.Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with manager and tracking progress (attends huddles)8.Demonstrates initiative and resourcefulness by making recommendation and communicating trends and issues to management9.Crossed trained in other areas within Patient Accounts10.Begin HBI Revenue Cycle classes11.Understands and maintains compliance with HIPAA guidelines when handling patient information12.Performs other duties as assigned