Patient Account Specialist

West Anaheim Medical Center; Anaheim (CA); On-site; USD 70,258,000 - 79,901,000; Full time

Job summary

West Anaheim Medical Center, part of Prime Healthcare, is seeking a Patient Account Specialist to submit claims, ensure proper coding, and maintain compliance with payer guidelines and state/federal regulations. You will analyze payments from insurers to maximize reimbursement of the hospital's receivables, proactively resolve issues with payers, and guide teams in resolving unpaid accounts.

This role emphasizes accuracy, multitasking, effective communication, and a commitment to quality care

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
• Customer Services experience required
• High School Graduate or GED Equivalent Preferred.

Responsibilities

• Submitting claims to the appropriate intermediaries and ensuring procedures and charges are coded in compliance with payer guidelines and state/federal regulations.
• Analyze payments from insurance companies to assure maximum and correct reimbursement of hospital receivables.
• Leads teams in the resolution of unpaid accounts and works with payers to identify and resolve issues.

Skills

Verbal Communication

Written Communication

Multi-tasking

Analytical skills

Customer service

Medical terminology

Education

High School Graduate or GED

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! West Anaheim Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

Overview

Founded in 1964, West Anaheim Medical Center is a 219-bed acute-care hospital dedicated to providing the community with high-quality, compassionate healthcare. Key services include general medical and surgical inpatient care and treatment, emergency services, surgical services, behavioral health, comprehensive heart center, and diagnostic imaging. For more information visit www.westanaheimmedctr.com.

Responsibilities

The Patient Account Specialist is responsible for submitting claims to the appropriate intermediaries and to insure 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

EDUCATION, EXPERIENCE, TRAINING

• 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
• Customer Services experience required
• High School Graduate or GED Equivalent Preferred.

Pay Transparency

West Anaheim Medical Center 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 $24.42 to $27.84. 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.

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

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf