- We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
- We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
- We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
- We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.
- Work closely with insurance companies and third-party payers to collect revenue for surgical services performed.
- This role is primarily focused on collecting payments from insurance companies as opposed from collecting from self-payers/individuals.
- Works closely with payer provider relations representatives
- Contacting insurance companies by email and/or phone to collect payments
- Handles contracted and non-contracted; HMO, PPO, EPO, POS, Worker's Com., self-pay and third-party reimbursement issues.
- Works all denials and corrected claims collaborating with the biller and/or Business Office Manager, insurance payers and/or patients on past due accounts
- Primary functions are credit balance management, patient balance resolution and non-patient (insurance) resolution
- Ensure payments by primary and secondary payers and/or self-pay patients are accurate
- Responsible for thorough and timely patient account follow up to ensure accurate accounts receivable reporting
- Accurate and timely follow up and resolution for all accounts receivable.
- Meeting and maintaining cash collection metrics and goals
- Effectively and independently handles second level reimbursement issues, contracted and non-contracted denials for serviced before and after procedures
- One or more years' experience in a related position working in a medical office, hospital, outpatient surgery center or related field with core duties related to medical insurance collections, billing, accounts receivable, A/R, collecting payments, collecting re-imbursements, or related training/certificates/diplomas
- In lieu of on-the-job experience new or recent college and university graduates with a desire to work in a challenging position within the healthcare industry that have completed an Associate's Degree or Bachelor's Degree will be considered
- Knowledge of MS Office including Excel and Word
- High school diploma, GED, related certificate/diploma of related training or Associate's Degree or Bachelor's Degree
- Ideally two or more years' experience working specifically into medical insurance collections, billing, accounts receivable, A/R, collecting payments, collecting re-imbursements from payer organizations or from the insurance company side
- Experience with Medical Billing Software and Applications
- Possess basic knowledge of medical terminology and health insurance billing.
- Strong communication skills, both verbally and in writing
- Customer service and patient service focus
- Ability to multi-task, think critically, and solve problems
- Ability to work in a fast-paced environment
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Accounts Receivable Representative - Bloomfield, United States - Surgery Care Affiliates
Description
Overview
Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care.
delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.
As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:
The new SCA Health represents who we are today and where we are going-and the growing career opportunities for YOU.
Specifically, you will work in the Accounts Receivable, or A/R department, within our regional business office and will be responsible for thorough and timely patient account follow up to ensure accurate accounts receivable reporting; following up with insurance companies and/or third party payers to ensure payments by primary and secondary payers and/or self-pay patients are accurate and timely
You will:
This is a fast-paced environment, which requires attention to detail, accountability, teamwork, and professional behavior and a focus that extends to patients, clients and other departments.
Qualifications
