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Patient Account Representative II

Role overview

Qualifications

  • One year of experience in medical authorization, coding, or health finance
  • High School diploma/GED or 10 years of work experience

Responsibilities

  • Process the insurance component of a patient's obligation using third party claims processing and payment rules
  • Follow up on denied claims by performing appeals and denial recovery procedures
  • Analyze credit balances on patient accounts and resolve
  • Identify process improvement opportunities and participate in improvement plans

Key facts

Other skills

  • Communication
  • Teamwork
  • Problem Solving

About the company

SSM Health logo

SSM Health

Hospitals & Health Care

SSM Health is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through one of the largest integrated delivery systems in the nation.The organization’s 40,000 team members and more than 12,800 providers are committed to providing exceptional health care services and revealing God’s healing presence to everyone they serve. With care delivery sites in Illinois, Missouri, Oklahoma and Wisconsin, SSM Health includes 23 hospitals, more than 300 physician offices and other outpatient and virtual care services, 12 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company and an accountable care organization. It is one of the largest employers in every community it serves. An early adopter of the electronic health record (EHR), SSM Health is a national leader for the depth of its EHR integration.Our Mission: Through our exceptional health care services, we reveal the healing presence of God.Learn more about SSM Health here: http://www.ssmhealth.com/system/about-ssmVisit jobs.ssmhealth.com to fulfill your calling with SSM Health.

Company details

Company typeXLarge
IndustryHospitals & Health Care
Company size10001

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Job description

It's more than a career, it's a calling.

MO-REMOTE

Worker Type:

Regular

Job Highlights:

This is a full-time, day-shift position working Monday-Friday from 8:30AM-5:00PM. The role requires one year of experience in medical authorization, coding or health finance experience. The candidate must reside within 2 hours from the hospital location.

Job Summary:

Responsible for processing patient accounts. Duties may include one or more of the following: processing insurance payments, following up on denied claims, and resolving credit balances. May work in multiple functional areas.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

  • Processes the insurance component of a patient's obligation using the third party claims processing and payment rules. Bills claims appropriately.
  • Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines and no response claims to resolve outstanding accounts.
  • Analyzes credit balances on patient accounts and resolves. Responds to refund request letters from insurance carriers.
  • Identifies process improvement opportunities and participates in improvement plans.
  • Works on special projects as needed.
  • May review the work of others.
  • Performs other duties as assigned.


EDUCATION

  • High School diploma/GED or 10 years of work experience


EXPERIENCE

  • One year experience

PHYSICAL REQUIREMENTS

  • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
  • Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
  • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
  • Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
  • Frequent keyboard use/data entry.
  • Occasional bending, stooping, kneeling, squatting, twisting and gripping.
  • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
  • Rare climbing.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS 

  • None

Department:

2064000037 Outpatient Services

Work Shift:

Day Shift (United States of America)

Scheduled Weekly Hours:

40

Benefits:

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

  • Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE). 

  • Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.

  • Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members. 

Explore All Benefits

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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