Patient Accounting Collections Specialist

Now hiring a Patient Accounting Collections Specialist

Follows-up, collects, and resolves all outstanding accounts receivable. Performs a variety of duties including accounts receivable follow-up, customer service, correspondence response, and daily reconciliation of activities. Meets established guidelines to ensure timely and accurate reimbursement for all billed charges.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

Full Time - Exempt: No
• Job is based Rev Hugh Cooper Admin Center
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Ideal Candidate: High School diploma, Healthcare clerical or customer service experience, Knowledge of ICD-10, HCPCS, CPT codes, Revenue Codes, UB04 and HCFA 1500 claim forms and an understanding of electronic processing of 837 and 835

• High School diploma or GED required.
• Less than 1-year healthcare clerical or customer service experience preferred.
• Must be passionate about contributing to an organization focused on continuously improving patient experiences and the health of our community.
• Experience with Microsoft Office Suite products preferred. Excellent organizational, problem-solving, verbal and written communication skills, along with, attention to detail and the ability to interact effectively with other functional areas and management teams are required.
• Must have a strong work ethic and demonstrated ability to work effectively in a team environment.
• Must be able to prioritize and manage a high-volume, workload. Must be able to work in a fast-paced environment and contend with continually changing payer regulations and requirements.
• Basic knowledge of ICD-10, HCPCS, CPT codes, Revenue Codes, UB04 and HCFA 1500 claim forms and an understanding of electronic processing of 837 and 835 is preferred.
• Basic knowledge of Coordination of benefits and the Medicare MSPQ preferred.
• Must have basic knowledge of various payer requirements, claim submission processes for major insurances carriers and intermediaries.
• Must have basic knowledge of the revenue cycle processes.
• Must have the ability to provide a high-speed DSL or cable modem for a home office. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
• Must be able to provide a confidential workspace that is HIPPA compliant and free from distractions.

• Performs accounts receivable follow-up activities for their assigned work queues and/or miscellaneous A/R reports.
• Responsible for contacting insurance companies, patients, and employers regarding outstanding claims.
• Responsible for providing any information (medical records, itemized statements, etc) requested by insurance companies to process claims.
• Must maintain a system to ensure timely follow up is completed for each outstanding claim.
• Responsible for identifying and reporting insurance payor issues to lead, providing all pertinent information to include examples, correspondence, EOBs, claims, etc.
• Consult with lead regarding next steps with difficult claims.
• Must communicate all issues to teammates and Follow-up & Collection Supervisor.
• Refer accounts, in accordance with PHS guidelines, to leadership for adjustment, agency placement or attorney referral.
• Cross train in the various Patient Accounting Department areas to be completely familiar with all aspects of patient accounting functions as they relate to collections.
• Perform other duties as assigned by the Follow-up & Collection Supervisor and/or Manager.
• Document accounts in accordance with established PHS policies and procedures.
• Effectively operates and is familiar with various computer systems. These may include the following: Epic, FinThrive, FISS/DDE, Presbyterian Health Plan Provider Portal, Payer portals, Microsoft Office Suite.
• Must be an effective team member with great communication skills.
• Must participate in team meetings and communicate work related ideas and concerns proactively.
• Must develop and maintain positive working relationships with team members and all PHS departments.
• Ensures that goals and objectives are met in conformity with PHS policies and procedures and CMS compliance rules and regulations.
• Maintains strictest confidentiality, adheres to all HIPAA guidelines/regulations.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.