Accounts Receivable Representative

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, https://careers.sca.health/why-sca, to learn more about our benefits.

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

Accountabilities / Responsibilities

Specifically, you will work in the Accounts Receivable, or A/R department, within our regional business office and will be responsible for thorough and timely patient account follow up to ensure accurate accounts receivable reporting; following up with insurance companies and/or third party payers to ensure payments by primary and secondary payers and/or self-pay patients are accurate and timely. You will: 

• Work closely with insurance companies and third-party payers to collect revenue for surgical services performed.
• This role is primarily focused on collecting payments from insurance companies as opposed from collecting from self-payers/individuals.
• Works closely with payer provider relations representatives
• Contacting insurance companies by email and/or phone to collect payments
• Handles contracted and non-contracted; HMO, PPO, EPO, POS, Worker’s Com., self-pay and third-party reimbursement issues.
• Works all denials and corrected claims collaborating with the biller and/or Business Office Manager, insurance payers and/or patients on past due accounts
• Primary functions are credit balance management, patient balance resolution and non-patient (insurance) resolution
• Ensure payments by primary and secondary payers and/or self-pay patients are accurate
• Responsible for thorough and timely patient account follow up to ensure accurate accounts receivable reporting
• Accurate and timely follow up and resolution for all accounts receivable.
• Meeting and maintaining cash collection metrics and goals
• Effectively and independently handles second level reimbursement issues, contracted and non-contracted denials for serviced before and after procedures

This is a fast-paced environment, which requires attention to detail, accountability, teamwork, and professional behavior and a focus that extends to patients, clients and other departments.

Qualifications

• One or more years’ experience in a related position working in a medical office, hospital, outpatient surgery center or related field with core duties related to medical insurance collections, billing, accounts receivable, A/R, collecting payments, collecting re-imbursements, or related training/certificates/diplomas
• In lieu of on-the-job experience--- new or recent college and university graduates with a desire to work in a challenging position within the healthcare industry that have completed an Associate’s Degree or Bachelor’s Degree will be considered
• Knowledge of MS Office including Excel and Word

Preferred Qualifications

• High school diploma, GED, related certificate/diploma of related training or Associate’s Degree or Bachelor’s Degree
• Ideally two or more years’ experience working specifically into medical insurance collections, billing, accounts receivable, A/R, collecting payments, collecting re-imbursements from payer organizations or from the insurance company side
• Experience with Medical Billing Software and Applications
• Possess basic knowledge of medical terminology and health insurance billing.
• Strong communication skills, both verbally and in writing
• Customer service and patient service focus
• Ability to multi-task, think critically, and solve problems
• Ability to work in a fast-paced environment