Collections Specialist/3rd Party-Patient Accounting - Presbyterian Healthcare Services
Albuquerque, NM 87113-2237
About the Job
Now hiring a Collections Specialist/3rd Party-Patient Accounting
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.
- High School degree or GED is required, short-term training on insurance collections and claims processing.
- Minimum six months experience in insurance follow-up. One year of similar medical facility, physicians office or experience with major carrier in claims processing preferred.
- Demonstrated ability to communicate effectively via telephone and in writing.
- Computer literate. Must be able to work closely with coworkers
- Performs accounts receivable follow-up activities for their assigned payers/accounts using monthly aged account work queues and/or A/R reports.
- Responsible for identifying and documenting insurance payor issues as they arise. Must communicate all issues to teammates and Follow-up & Collection Supervisor. Responsible for maintaining a file containing all pertinent information for each issue to include correspondence, EOBs, claims, etc.
- Must be an effective team member with good communication skills. Must participate in team meetings, communicate work related ideas and concerns proactively, and assist in finding appropriate resolutions.
- Responsible for contacting insurance companies, patients, and employers regarding outstanding hospital 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.
- Maintain collection reports consisting of outstanding accounts assigned. Must work and document report according to Patient Accounting Department policies and procedures. Responsible for following up on all accounts listed on the report until resolved.
- Refer accounts, in accordance with PHS guidelines, to Follow-up & Collection Manager for write-off, agency, or attorney referral. Refer difficult claims to Collection Supervisor or Manager for advice and/or assistance.
- Must work closely with all outside agencies contracted with the Patient Accounting Department and assist them with account resolution for any accounts assigned to them by the Follow-up & Collection Supervisor/Manager.
- 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.
- Adhere to all PHS and Patient Accounting Department policies and procedures to promote a smooth working environment, and uphold the PHS vision by practicing the CARES behaviors at all times.
- Perform other duties as assigned by the Follow-up & Collection Supervisor and/or Manager.
- Works bundled episode accounts and adds modifier in Charge Review WQs
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.
Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.