Stanford Health Care
Patient Account Representative II
Stanford Health Care, Palo Alto, California, United States, 94306
Stanford Health Care is seeking a Patient Account Representative (PAR) to work in the Patient Financial Services (PFS) operations. The PAR is responsible for the timely and accurate processing of insurance balance patient claims in accordance with contracts and policies.
Responsibilities
The PAR's focus may be on a mix of various responsibilities from across the PFS operations, including: 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. 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 Expertise in Excel (i.e. pivot tables, formulas) preferred 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 Stanford Health Care is an Equal Opportunity Employer and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment.
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The PAR's focus may be on a mix of various responsibilities from across the PFS operations, including: 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. 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 Expertise in Excel (i.e. pivot tables, formulas) preferred 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 Stanford Health Care is an Equal Opportunity Employer and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment.
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