Patient Account Specialist

Prime Healthcare; Ontario (CA); On-site; CAD 44,000 - 55,000; Full time

Benefits offered by this job

Paid time off

Tuition reimbursement

Medical, dental & vision coverage

Job summary

Prime Healthcare is seeking a Patient Account Specialist to submit claims to intermediaries and ensure proper coding in line with payer guidelines and regulations. The role involves payment analysis of managed care contracts to maximize/recover hospital receivables, and leading teams to resolve unpaid accounts.

Responsibilities include working with payers, applying regulations to ensure compliant payment practices, and driving timely reimbursements while maintaining high-quality service

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 Equalivent Required (effective 4/1/14 for all new hires)

Responsibilities

• The Patient Account Specialist is responsible for submitting claims to the appropriate intermediaries and to ensure that procedures and charges are coded in compliance with payer guidelines and state/federal regulations. Under supervision, analyzes payments from managed care contracts to determine appropriate reimbursement and leads teams in resolving unpaid accounts.

Skills

Billing experience

Written & verbal communication

Analytical and problem solving

Customer service

Medical terminology

Education

High School/GED

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

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

• 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 Required (effective 4/1/14 for all new hires)

Pay Transparency

Prime Healthcare 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 $23.70 to $29.00. 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