Location Address:

Compensation Pay Range:

Summary:

Responsibilities:

• Performs accounts receivable follow-up activities for their assigned work queues and/or miscellaneous A/R reports.
• Responsible for contacting insurance companies, patients, and employers regarding outstanding claims.
• Responsible for providing any information (medical records, itemized statements, etc) requested by insurance companies to process claims.
• Must maintain a system to ensure timely follow up is completed for each outstanding claim.
• Responsible for identifying and reporting insurance payor issues to lead, providing all pertinent information to include examples, correspondence, EOBs, claims, etc.
• Consult with lead regarding next steps with difficult claims.
• Must communicate all issues to teammates and Follow-up & Collection Supervisor.
• Refer accounts, in accordance with PHS guidelines, to leadership for adjustment, agency placement or attorney referral.
• Cross train in the various Patient Accounting Department areas to be completely familiar with all aspects of patient accounting functions as they relate to collections.
• Perform other duties as assigned by the Follow-up & Collection Supervisor and/or Manager.
• Document accounts in accordance with established PHS policies and procedures.
• Effectively operates and is familiar with various computer systems. These may include the following: Epic, FinThrive, FISS/DDE, Presbyterian Health Plan Provider Portal, Payer portals, Microsoft Office Suite.
• Must be an effective team member with great communication skills.
• Must participate in team meetings and communicate work related ideas and concerns proactively.
• Must develop and maintain positive working relationships with team members and all PHS departments.
• Ensures that goals and objectives are met in conformity with PHS policies and procedures and CMS compliance rules and regulations.
• Maintains strictest confidentiality, adheres to all HIPAA guidelines/regulations.

Qualifications:

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services