Patient Account Representative

Patient Account Representative - Billing & Coding, AR, Collections - Treasure Valley Hospital JOB DESCRIPTION.SHARE.HTML CAROUSEL PARAGRAPH JOB DESCRIPTION.SHARE.HTML
•   Boise, Idaho
•   Treasure Valley Hospital
•   Billing
•   Regular
•   Full-time
•   4
•   USD $21.00/Hr.
•   USD $23.00/Hr.
•   39105 SCA Health Job Description Overview

Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care. As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:
•   We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
•   We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
•   We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
•   We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines. 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. Click here to learn more about our benefits. The new SCA Health represents who we are today and where we are going-and the growing career opportunities for YOU.
Responsibilities

The Patient Account Representative will be responsible for thorough and timely patient account follow up with insurance companies to ensure accurate accounts receivable reporting; to ensure payments by primary and secondary payors and/or self-pay patients are accurate. 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 You will work in the Accounts Receivable Department, within our business office and will be responsible for thorough and timely patient account follow up to ensure accurate accounts receivable reporting; following up with insurance companies and/or third-party payers to ensure payments by primary and secondary payers and/or self-pay patients are accurate and timely. JOB KNOWLEDGE:
•   Credit Balance & Insurance Resolution :
•   Resolve patient and insurance account balances (primary, secondary, self-pay).
•   Work with insurance companies to ensure payments are processed correctly.
•   Manage and resolve outstanding claims or accounts in a timely manner.
•   Achieve cash collection metrics and goals set by the department.
•   Accounts Receivable Follow-Up :
•   Ensure accurate and timely follow-up on all accounts receivable.
•   Maximize facility reimbursement by working with insurance providers to resolve issues.
•   Denials and Claims :
•   Handle denials and corrected claims independently and collaborate with billing team to resolve.
•   Understand payer contracts and utilize them for accurate billing and reimbursement.
•   Customer Interaction :
•   Provide professional responses to patient and payer inquiries.
•   Work with patients and providers to explain insurance coverage, EOBs, and billing issues. ESSENTIAL POSITION REQUIREMENTS :
•   Billing & Accounts Receivable:
•   Bill and re-bill primary, secondary, and tertiary insurance claims daily.
•   Maintain knowledge of third-party billing requirements and current insurance coverage allowances.
•   Ensure accurate and timely follow-up of unpaid balances, including processing claims, re-bills, and remittances.
•   Work with insurance representatives to resolve denied claims and adjust accounts as needed.
•   Meet productivity goals and follow departmental guidelines for billing and claims management. Communication & Customer Service:
•   Communicate effectively with insurance representatives, patients, and other staff to resolve issues and ensure proper reimbursement.
•   Notify the Billing Office Manager of any issues or claims that cannot be billed on the date received.
•   Maintain confidentiality and professionalism in all patient and departmental communications. Problem-Solving & Decision-Making:
•   Utilize judgment to resolve complex billing issues and provide patient assistance in reconciling account balances.
•   Handle patient and insurance inquiries independently, using experience and knowledge to ensure accurate account resolution.
•   Productivity & Time Management:
•   Maintain a high level of productivity, ensuring timely billing and follow-up on a minimum of 70% of accounts needing attention.
•   Prioritize tasks, demonstrate initiative, and meet deadlines while maintaining accuracy.
•   Support team efforts to achieve departmental goals and contribute to a positive work environment. Compliance & Attitude:
•   Adhere to all hospital policies, procedures, and industry best practices.
•   Display a positive, flexible attitude toward change and work collaboratively with colleagues.
•   Demonstrate respect for co-workers, patients, and hospital procedures, ensuring a professional and respectful environment. POSITION PURPOSE:
•   Work closely with insurance companies and th