Patient Account Representative - Medical Billing - Treasure Valley Hospital

Overview

At SCA Health, we believe health care is about people – the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization.

As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.

What sets SCA Health apart isn’t just what we do, it’s how we do it
. Each decision we make is rooted in seven core values
:

• Clinical quality
• Integrity
• Service excellence
• Teamwork
• Accountability
• Continuous improvement
• Inclusion

Our values aren’t empty words – they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.

At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, (Use the "Apply for this Job" box below). to learn more about our benefits.

Your ideas should inspire change. If you join our team,
they will
.

JOB KNOWLEDGE

Credit Balance & Insurance Resolution:

• Resolve patient and insurance account balances (primary, secondary, self-pay).
• Work with insurance companies to ensure payments are processed correctly.
• Manage and resolve outstanding claims or accounts in a timely manner.
• Achieve cash collection metrics and goals set by the department.

Accounts Receivable Follow-Up:

• Ensure accurate and timely follow-up on all accounts receivable.
• Maximize facility reimbursement by working with insurance providers to resolve issues.

Denials and Claims:

• Handle denials and corrected claims independently and collaborate with billing team to resolve.
• Understand payer contracts and utilize them for accurate billing and reimbursement.

Customer Interaction:

• Provide professional responses to patient and payer inquiries.
• Work with patients and providers to explain insurance coverage, EOBs, and billing issues.

ESSENTIAL POSITION RESPONSIBILITIES

Billing & Accounts Receivable:

• Bill and re-bill primary, secondary, and tertiary insurance claims daily.
• Maintain knowledge of third-party billing requirements and current insurance coverage allowances.
• Ensure accurate and timely follow-up of unpaid balances, including processing claims, re-bills, and remittances.
• Work with insurance representatives to resolve denied claims and adjust accounts as needed.
• Meet productivity goals and follow departmental guidelines for billing and claims management.

Communication & Customer Service:

• Communicate effectively with insurance representatives, patients, and other staff to resolve issues and ensure proper reimbursement.
• Notify the Billing Office Manager of any issues or claims that cannot be billed on the date received.
• Maintain confidentiality and professionalism in all patient and departmental communications.
  Problem-Solving & Decision-Making:
• Utilize judgment to resolve complex billing issues and provide patient assistance in reconciling account balances.
• Handle patient and insurance inquiries independently, using experience and knowledge to ensure accurate account resolution.

Productivity & Time Management:

• Maintain a high level of productivity, ensuring timely billing and follow-up on a minimum of 70% of accounts needing attention.
• Prioritize tasks, demonstrate initiative, and meet deadlines while maintaining accuracy.
• Suppor…