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Day - 08 Hour (United States of America)

This is a Stanford Health Care job.

A Brief Overview

The Patient Account Representative (PAR) is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies.

The PAR works in various capacities to support the primary goal of the business office to resolve of unpaid, underpaid, denied or unresolved patient accounts.

Depending on the specific team, the PAR's focus may be on a mix of various responsibilities from across the Patient Financial Services (PFS) operations.

Responsibilities may include :

• Accounts receivable collections and payer follow-up
• Payer clerical and technical denial review and request processing including basic appeals
• Payment posting and batch reconciliation
• Credit balance review and resolution
• Retroactive eligibility and registration
• Underpayment reconciliation
• Client or other special billing

The PAR II works primarily in Epic, under general supervision, to perform the full range of duties for assigned class. This role requires a strong working knowledge of systems and processes.

A PAR II is expected to resolve standard queries and problems independently and works on assignments that are moderately complex in nature where critical thinking is required.

Locations

Stanford Health Care

What you will do

Responding to requests from the payer, such as providing medical records or other documentation either by mail or via payer portals

Following up on unresolved patient accounts in Epic by contacting the payer by phone or via the portal

Resolving claim edits

Reviewing payer variances and pursuing underpayments to payers

Reviewing and resolving payer rejections, denials, and performing appeals as necessary

Electronic or hardcopy claims editing and submission to payers

Recognizing potential trends and escalating them as appropriate

Posting payments in Epic, as well as related adjustments

Resolving credit balances

Completing basic charge corrections

Education Qualifications

High school diploma or GED equivalent

Experience Qualifications

Two (2) years of progressively responsible and directly related work experience

Required Knowledge, Skills and Abilities

Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager

Can maintain professional communication with various PFS staff, payers, and patients regarding the billing of services.

Ability to follow oral and written instructions and interpret institutional and other policies accurately

Ability to communicate clearly and professionally both verbally and in writing

Ability to maintain confidentiality of sensitive information

Ability to perform basic mathematics

Ability to plan, prioritize, and meet deadlines

Ability to work effectively with individuals at all levels of the organization

Knowledge of accounts receivable software systems and medical billing operations

Familiarity with medical reimbursement policies and procedures and medical terminology

Knowledge of payer landscape, including Medicare, Medicaid, Workers’ Compensation, Managed Care, or other Commercial insurance

These principles apply to ALL employees :

SHC Commitment to Providing an Exceptional Patient & Family Experience

Know Me : Anticipate my needs and status to deliver effective care

Show Me the Way : Guide and prompt my actions to arrive at better outcomes and better health

Coordinate for Me : Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment.

Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and / or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above.

People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply.

Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale : Generally starting at $32.48 - $36.57 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training.

This pay scale is not a promise of a particular wage.