Account Representative

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states, providing over 2.6 million patient visits annually. It is one of the nation’s leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information, or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories.

Responsibilities

• The Account Representative is responsible for posting all incoming payments to correct patient accounts daily.
• Inputs and retrieves data from computer systems.
• Reconciles accounts daily.
• Applies payments to patient accounts accurately and efficiently.
• Distributes billing to appropriate personnel.
• Reviews and follows up on authorizations and specialty referrals.
• Maintains current knowledge of contracts and state Worker’s Compensation fee schedules.
• Handles incoming and outgoing hospital mail, recognizing and correcting mailing errors immediately.
• Uses tact and discretion when handling inquiries from patients and families.
• Performs accurate and timely payment analysis of managed care contracts to ensure appropriate reimbursement.
• Analyzes insurance payments to maximize and correct reimbursement, working proactively with payers and internal resources.
• Applies relevant state and federal regulations to ensure compliance.
• Posts all incoming payments daily, inputs and retrieves data, and reconciles accounts.
• Applies contractual adjustments and manages underpayments / denials for follow-up and revenue collection.
• This role is based full-time in-office.

Qualifications

Prime Healthcare offers competitive compensation and a comprehensive benefits package, including paid time off, 401K, medical, dental, and vision coverage, tuition reimbursement, and voluntary benefits. The estimated total compensation for this role ranges from $21.00 to $25.00 per hour, determined based on skillset, experience, education, and credentials.

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