We are seeking an Account Representative, sometimes referred to as a Patient Financial Services Representative, or Patient Account Services Representative. The Account Representative is responsible for accurately posting and reconciling daily payments, applying contractual adjustments, and ensuring patient accounts reflect correct and timely reimbursement. The Account Representative analyzes insurance payments for compliance with managed care contracts and state and federal regulations, resolves underpayments or denials, distributes billing and correspondence appropriately, and provides professional support to patients and internal departments.

*This is an on-site opportunity in Weslaco, Texas*

Shifts Available: Days (No Weekends or Holidays)

Employment Type: Full-time

Hours: 8-hour shift 

Location: Central Billing Office – Weslaco, TX

Here are some of the benefits of working at Prime Healthcare:

• Health, dental, and vision insurance options
• Paid vacation, sick time and holidays
• Bereavement leave, FMLA and other leave options
• Employer 401K options
• Tuition reimbursement options
• Life, disability, and other insurance options
• Many other amazing benefits

Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/

Essential Duties and Responsibilities (includes, but not limited to):

• Accurately post and reconcile daily incoming payments, apply contractual adjustments, and maintain correct patient account balances within hospital systems
• Analyze insurance payments and managed care contracts to ensure accurate reimbursement and compliance with state and federal regulations, including Worker’s Compensation fee schedules
• Identify, investigate, and escalate underpayments or denials while collaborating with payers and internal departments to optimize revenue collection
• Distribute billing appropriately, manage hospital-related incoming and outgoing mail, and promptly correct mailing discrepancies
• Provide professional, tactful communication when assisting patients, families, and internal stakeholders regarding account inquiries and payment matters

Before we go any further, we do have some deal-breakers. You must have: 

EDUCATION, EXPERIENCE, TRAINING

1. Ability to multi-task, prioritize needs to meet required timelines
2. Analytical, mathematical and problem-solving skill preferred
3. Customer Services experience preferred
4. Effective written and verbal communication skills
5. Experience in accounts payable, accounts receivable or cashier experience preferred
6. Familiar with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred
7. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)
8. Knowledge of basic understanding medical coding and third-party operating procedures and practices
9. Knowledge of multiple insurance billing requirements and 6 mo.-1 year of billing experience preferred
10. Medical and Insurance terminology essential