Associate Accounts Receivable Representative (Remote)

Overview

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.

Responsibilities

The Associate Accounts Receivable Representative 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. This role is a vital position in the revenue cycle process.   The ‘A/R Rep’ will function within the Center’s policies and procedures, support SCA Values, SCA Vision and SCA Mission.  In return, we offer a great benefits package including health and dental insurance options, PTO, 401K, and more.  All of which begin on your first day of employment. 

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: 

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

Qualifications

Requirements for our roles:

• Denials and appeals experience required
• Healthcare experience required
• Familiarity with EOB and reading medical policies from payers required
• High School Diploma or GED