Job Description

Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.

As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:

• We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
• We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
• We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
• We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.

The new SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU.

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.

• 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

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