Patient Account Representative

Title: Patient Account Representative 

Location: Laguna Hills

Department: Hospice -Outpatient

Status: Full-time

Shift: Days (8hr shifts)

Pay Rate: $25.71/hr - $37.28/hr

At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

This position requires the full understanding and active participation in fulfilling the mission of Saddleback Medical Center. It is expected that the employee demonstrate behavior consistent with our core values: Integrity, Accountability, Best Practices, Compassion and Synergy. The employee shall support Saddleback Medical Center’s strategic plan and participate in and advocate performance improvement/patient safety activities.

The Patient Account Rep III position requires knowledge of all Medi-Cal, Cal-optima, Medicare & Managed care contracts to review all payments received.  This position is also required to identify research and prepare insurance refunds to ensure accurate reimbursements.  The Patient Account Rep III works under the direction of the Hospice A/R Manager to coordinate all financial aspects of patient admissions, and visits to include Benefits, insurance verification, pre- certification information, authorization and patient’s change of insurance process. To encompass all payer types.  Assures Insurance information is accurate. Knowledge of insurance payor types

Essential Functions and Responsibilities of the Job

• Ability to submit Medicare, Commercial, and private pay claims in a timely fashion
• Demonstrates ability to precisely review and calculate all Medi-Cal, Medicare, Cal-optima and managed care payments to ensure accurate reimbursement
• Demonstrates ability to research and/or follow up on insurance refunds to ensure accurate account balances
• Monitors, Pays, Updates all Invoices from different vendors. Document appropriately in the Hospice/Health system all correspondences and other transactions in interacting with Accounts Payable and Vendors
• Ability to complete end-of the month closing and statistical reports
• Demonstrates ability to monitor and analyze Accounts Receivable (A/R) to ensure minimal number of days in A/R
• Ability to verify insurance coverage for all payer types for patient admissions. Makes written and or verbal inquires to third party payer to verify insurance benefits, eligibility and insurance status
• Obtains and tracks all authorizations for Palliative and hospice patients
• Ability to be at work and be on time
• Ability to follow company policies, procedures and directives
• Ability to interact in a positive and constructive manner
• Ability to prioritize and multitask

Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.

Experience

• Previous hospital experience including knowledge of commercial, government and managed care insurance
• Knowledge of Billing and follow-up procedures
• Experience in Typing
• Use of 10-key calculator
• Knowledge of Microsoft Office Suite

Education

• High School diploma or equivalent preferred