Patient Account Representative

Advocate Health Care; Laurinburg (NC); On-site; USD 42,000 - 64,000; Full time

Job summary

Scotland Health Care System in Laurinburg, NC seeks a dedicated Revenue Cycle Specialist to examine denied and underpaid claims, explain the discrepancies to payers, and support strategies to reduce accounts receivable. You will maintain payer files, document interactions, and ensure HIPAA compliance as part of a collaborative team.

The role emphasizes accuracy, process improvement, and clear communication with departments and payers, with opportunities to participate in ongoing training and

Qualifications

• Examine denied and underpaid claims and identify reasons for discrepancies.
• Provide payers with specific reasons for suspected underpayments and analyze payer denial reasons.
• Work with management to identify trends and address root causes of denials.
• Maintain knowledge of regulations and payer requirements to report billing compliance issues.
• Update and maintain payer files with contact names, addresses, phone numbers, websites and other pertinent information; thoroughly document all interactions with payers.
• Handle communications from payers and internal departments via phone and email.
• Participate in continuous quality improvement efforts and track progress with management.
• Demonstrate initiative by communicating trends and issues to management.
• Cross-trained in other areas within Patient Accounts.
• Begin HBI Revenue Cycle classes.
• Understand and maintain HIPAA compliance when handling patient information.
• Performs other duties as assigned.

Responsibilities

• Examine denied and underpaid claims and determine discrepancy reasons.
• Communicate with payers and internal departments to resolve issues.
• Identify and report trends to management for AR reduction.

Job description

Department: Scotland Memorial Hospital - Patient Financial Services Status: Full time Shift: 1st (United States of America) Schedule Details/Additional Information: Monday- Friday

Job Description:

• 1.Examines denied and underpaid claims to determine reasons for discrepancies
• 2.Provide payers with specific reasons for the suspected underpayments and analyzes denial reasons given by payers
• 3.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 discrepancies
• 5.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 payers
• 6.Effectively handles all communication, including telephone and email from payers and departments within Revenue Cycle
• 7.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 management
• 9.Crossed trained in other areas within Patient Accounts
• 10.Begin HBI Revenue Cycle classes
• 11.Understands and maintains compliance with HIPAA guidelines when handling patient information
• 12.Performs other duties as assigned

Careers At Scotland Health Care System

we’re proud to employ a team of dedicated professionals who embody the Scotland Way. Founded in 1946, Scotland Health Care System is a community-owned, not-for-profit organization serving Laurinburg, North Carolina. Our mission is simple yet powerful: to deliver safe, high-quality, compassionate, and sustainable health care to everyone in need. We offer a full spectrum of services—including inpatient, outpatient, and emergency care—along with specialized programs in cancer treatment, cardiac care, surgical services, and women’s health. Our culture is built on caring—for our patients and for our people. We believe that when we take exceptional care of our employees, they can provide exceptional care to our communities. That’s why we offer:

• Competitive compensation
• Family-friendly benefits including Paid Parental Leave and On-Site Childcare
• Flexible scheduling
• Exclusive savings programs
• Career growth and advancement opportunities

if you’re looking for more than just a job—if you want a meaningful career where you can make a difference—Scotland Health Care System is the place for you. Scotland Health Care System in Laurinburg, North Carolina is proud to be the community's health care system. We are a community owned and controlled not-for-profit organization that includes Scotland Memorial Hospital, Scotland Physicians Network with sixteen medical practices, Scotland Regional Hospice (formerly Hospice of Scotland County), Scotland Family Counseling Center, and Scotland Memorial Foundation. Here at Scotland Health Care System, we understand that healthcare is evolving. Advances in medicine and strides in technology are providing local communities access to better healthcare. It is our desire to provide you the best care possible. Our staff will be here to help you and your loved ones when the need arises.

Our Beliefs About Our Future:

To successfully accomplish our Mission and Vision our transformation must include creative and innovative changes in what we do and how we do it. We must change from a hospital and provider-centric model to a patient-centered, ambulatory model. There will be a continued focus on moving the industry to an increasingly ambulatory based delivery model focused on the health of the individual patient and the overall health of the population we serve. New payment models will incent us to better coordinate our patient’s care along the continuum of services. This includes both how our patients are treated and how their treatment information flows. New partners, arrangements, and competitors will emerge for us as a result of the new treatment and payment models. We will be strategically advantaged by coordinating access to a comprehensive continuum of care. Patients and their families will behave more like Consumers, expecting more Value, Convenience, and Access, in addition to caring and compassionate Service. Limited opportunities to pursue Smart Growth will necessitate us focusing our strategic efforts and resource allocation decisions.