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Patient Financial Services Follow Up Rep, FT, Days, - Remote

Prisma Health

Role overview

Qualifications

  • High School diploma or equivalent OR post-high school diploma/highest degree earned
  • Two (2) years medical billing, customer service, follow up and/or medical office experience
  • CRCA preferred
  • CRCR preferred

Responsibilities

  • Accurate and timely follow up on billed accounts receivable variances, no payments, and denials
  • Analyze prior account activity and communicate with payers for outstanding accounts
  • Perform daily duties related to collections and escalate accounts as appropriate
  • Identify trends and contribute to PFS department matrix

Key facts

Hard skills

Other skills

  • Microsoft Office
  • Customer Service
  • Detail Oriented
  • Analytical Skills
  • Communication

About the company

Prisma Health logo

Prisma Health

Hospitals & Health Care

Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. The company has one Purpose: Inspire health. Serve with compassion. Be the difference. Prisma Health is comprised of two affiliates: Prisma Health–Upstate and Prisma Health– Midlands. Together they are dedicated to improving the health of all South Carolinians through improved clinical quality, access to care and patient experience, while also addressing the rising cost of health care. The affiliates are nationally recognized as some of the best places to work and to receive care. With more than 30,000 team members, physicians and volunteers, Prisma Health is the state’s largest private employer. Prisma Health works to improve the health of the local communities in the Midlands and Upstate regions through its community health programs. As one of the 50 largest health systems in the country, Prisma Health is committed to academic and clinical research excellence and focuses on educating the next generation of physicians, nurses, dentists and other medical professionals. The Prisma Health executive home office is in Greenville, South Carolina. For more information, visit www.prismahealth.org. ALERT: We will never request personal information and/or money in exchange for an interview and we do not conduct interviews via Google Meet or Google Chat. There have been reports of malicious people posing as Prisma Health hiring managers and conducting interviews with candidates via Google Meet or Google Chat. This is a phishing scam that could result in them taking your identity and/or money. Our hiring managers and recruiters do not conduct interviews via Google Meet or Google Chat. If you are contacted by someone claiming to be a Prisma Health team member, and they ask you to interview via a Google app, end communication immediately and report the action to the police.

Company details

Company typeXLarge
IndustryHospitals & Health Care
Company size10001

Links

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Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Responsible and accountable for accurate and timely follow up, including variances, no payments, denials for all payers on billed accounts receivable. Ensures accounts are followed up on in a timely manner with diligent focus on all including, but not limited to aged and high dollar accounts. Follows up and pursues identified payer variances after comparing expected to actual reimbursement received. Responsible for working with other departments when issues arise such as missing payments, payer delays, and technical denials. Demonstrates exceptional relationships with external payers and internal departments in accordance with Prisma Health Standard of Behaviors and Compliance.

Essential Functions

  • All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference.

  • Analyses and reviews prior account activity and takes necessary actions including calling payer or utilizing payer websites for current status of outstanding accounts receivable (AR). Takes necessary actions to correct claim or obtain any requested information to the payer. Utilizes all appropriate workflows and completes appropriate and detail notes on every account preparing for next steps and/or resolution.  

  • Performs daily duties related to collections, variances and/or technical denials in a manner that constantly drives the account towards resolution, while challenging unacceptable responses from payers. Understands, interprets and applies managed care contract terms to accounts for payer resolution.  

  • Escalates accounts when appropriate, including but not limited with payer, internally and/or patient when appropriate in accordance with the Prisma Health escalation guidelines in order to minimize aging.  

  • Identifies trends and repeated problems and/or charge corrections to management.  

  • Contributes to PFS department matrix. Utilizes time and resources, assisting co-workers as time allows.   

  • Productivity and quality of work must be met. Identifies areas for improvements. Monitors quality levels, identifies root cause of quality problems and owns/acts on quality problems.   

  • Performs other duties as assigned.

Supervisory/Management Responsibilities

  • This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Requirements

  • Education - High School diploma or equivalent OR post-high school diploma/highest degree earned

  • Experience - Two (2) years medical billing, customer service, follow up and/or medical office experience.  

In Lieu Of

  • NA
     

Required Certifications, Registrations, Licenses

  • CRCA preferred.

  • CRCR preferred.

Knowledge, Skills and Abilities

  • Proficient in Microsoft Office applications including Word, Excel, Outlook, and Teams

    Communication skills

  • Understands, promotes and adheres to all matters of compliance with laws and regulations.  

  • Maintains professional growth and development through seminars, workshops, in-service meetings, current literature and professional affiliations to keep abreast of latest trends in field of expertise. 

  • Medical billing, follow up and/or medical office skills

  • Analytical skills

  • Attention to detail

Work Shift

Day (United States of America)

Location

Patewood Outpt Ctr/Med Offices

Facility

Corporate

Department

Patient Financial Services

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

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MR

Marcus Rivera

Chief Revenue Officer

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