Patient Account Representative - Treasure Valley Hospital

SCA Health; Boise (ID); On-site; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401k with company match

Paid time off

Life and disability insurance

Job summary

SCA Health is seeking a Patient Account Representative to manage patient accounts and insurance follow-up in our Boise area facilities. You will generate statements, respond to patient inquiries, and ensure accurate AR reporting while supporting SCA’s values and mission.

Responsibilities include resolving denials, understanding payer contracts, and collaborating with payer relations to optimize reimbursements.

Qualifications

• Candidate MUST HAVE knowledge of medical billing, payer follow-up, payer contracts, appeals, self-pay billing, Medicare and Medicaid billing, AR posting.
• Two years’ experience in a medical office as a patient account representative or similar role.
• Experience in hospital, outpatient surgery center or related field is a MUST; familiarity with medical terminology and billing software.

Responsibilities

• The Patient Account Representative will perform thorough and timely patient account follow up with insurances to ensure accurate AR reporting and payments.
• Generate daily patient statements and handle patient calls with timely, professional responses and resolutions.
• Follow center policies, procedures, and best practices for resolution and reassignments of accounts.
• Maintain knowledge of payer contracts and explanations of benefits; collaborate with payers and centers.
• Handle denials and corrected claims, coordinating with billers and managers to resolve past-due accounts.

Skills

Medical billing

Customer service

Communication skills

Attention to detail

Education

Associate’s Degree or equivalent

Tools

Excel

Medical billing software

Job description

Overview

At SCA Health, we believe

At SCA Health, we believe health care is about people - the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization.

As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.

What sets SCA Health apart isn’t just what we do, it’s how we do it

Each decision we make is rooted in seven core values:

• Clinical quality
• Integrity
• Service excellence
• Teamwork
• Accountability
• Continuous improvement
• Inclusion

Our values aren’t empty words - they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.

At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.

Your ideas should inspire change. If you join our team, they will.

Responsibilities

The Patient Account Representative will be responsible for thorough and timely patient account follow up with insurances to ensure accurate accounts receivable reporting; to ensure payments by primary and secondary payers and/or self-pay patients are accurate. The PAR will be responsible for daily generation of patient statements. The PAR will be responsible for answering patient calls and correspondence while providing timely, accurate, professional responses and resolution. The PAR will function within the Center’s policies and procedures, support SCA Values, SCA Vision and SCA Mission.

Two opening shifts 5:00am - 1:30pm and one from 10:30am - 7:00pm.

Key Responsibilities

• Primary functions are credit balance management, patient balance resolution and non-patient (insurance) resolution.
• Accurate and timely follow up and resolution for all accounts receivable.
• Meeting and maintaining cash collection metrics and goals.
• Maximized facility reimbursement.
• Understands each payer contract and will utilize to ensure payments received are correct.
• Understands and can explain the Explanation of Benefits received from any payer.
• Works closely with payer provider relations representatives.
• Has thorough knowledge of ASC Allowable procedures.
• Handles contracted and non-contracted; HMO, PPO, EPO, POS, Worker’s Com., self-pay and third-party reimbursement issues.
• Effectively and independently handles second level reimbursement issues, contracted and non-contracted denials for serviced before and after procedures.
• Works all denials and corrected claims collaborating with the biller and/or Business Office Manager, insurance payers and/or patients on past due accounts.
• Follow center policies, procedures, and best practices for resolution and reassignment of accounts.
• Possess basic knowledge of medical terminology and health insurance billing.
• Have ability to communicate effectively with patient, physicians, and other teammates

Qualifications

• Associate’s Degree or equivalent from a two-year College or technical school; and two years’ experience in a medical office as a patient account representative.
• Candidate MUST HAVE knowledge of medical billing, payer follow-up, payer contracts, appeals, self-pay billing, Medicare and Medicaid billing, AR posting, along with excellent customer service skills.
• Experience in a hospital, outpatient surgery center or related field is a MUST; Computer experience, Excel, Word, Medical Billing Software and Applications; Working knowledge of Medical Terminology.

USD $18.00/Hr. USD $22.00/Hr.