PB-AR Follow Up Representative, FT, Days* Remote* at Prisma Health

Greenville, South Carolina, United States -

Full Time

Start Date

Immediate

Expiry Date

29 May, 26

Salary

0.0

Posted On

28 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Account Reconciliation, Payer Follow Up, Denial Management, Variance Analysis, Medical Billing, Customer Service, Contract Interpretation, Claims Correction, Data Analysis, Compliance Adherence, Communication, Attention To Detail, Time Management, Escalation Management, Quality Monitoring, Trend Identification

Industry

Hospitals and Health Care

Description

Inspire health. Serve with compassion. Be the difference. Job Summary Responsible and accountable for accurate and timely follow up, including variances, no payments, denials for all payers on billed accounts receivable. Ensures accounts are followed up on in a timely manner with diligent focus on all including, but not limited to aged and high dollar accounts. Follows up and pursues identified payer variances after comparing expected to actual reimbursement received. Responsible for working with other departments when issues arise such as missing payments, payer delays, and technical denials. Demonstrates exceptional relationships with external payers and internal departments in accordance with Prisma Health Standard of Behaviors and Compliance. This is a remote position. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Analyses and reviews prior account activity and takes necessary actions including calling payer or utilizing payer websites for current status of outstanding accounts receivable (AR). Takes necessary actions to correct claim or obtain any requested information to the payer. Utilizes all appropriate workflows and completes appropriate and detail notes on every account preparing for next steps and/or resolution. Performs daily duties related to collections, variances and/or technical denials in a manner that constantly drives the account towards resolution, while challenging unacceptable responses from payers. Understands, interprets and applies managed care contract terms to accounts for payer resolution. Escalates accounts when appropriate, including but not limited with payer, internally and/or patient when appropriate in accordance with the Prisma Health escalation guidelines in order to minimize aging. Identifies trends and repeated problems and/or charge corrections to management. Contributes to PFS department matrix. Utilizes time and resources, assisting co-workers as time allows. Productivity and quality of work must be met. Identifies areas for improvements. Monitors quality levels, identifies root cause of quality problems and owns/acts on quality problems. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - High School diploma or equivalent OR post-high school diploma/highest degree earned Experience - Two (2) years medical billing, customer service, follow up and/or medical office experience. In Lieu Of NA Required Certifications, Registrations, Licenses CRCA preferred. CRCR preferred. Knowledge, Skills and Abilities Communication skills Understands, promotes and adheres to all matters of compliance with laws and regulations. Maintains professional growth and development through seminars, workshops, in-service meetings, current literature and professional affiliations to keep abreast of latest trends in field of expertise. Medical billing, follow up and/or medical office skills Analytical skills Attention to detail Work Shift Day (United States of America) Location Corporate Facility 7001 Corporate Department 70019122 PBO-Patient Account Services Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health. Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. Our 32,000 team members are dedicated to supporting the health and well-being of you and your family. Our promise is to: Inspire health. Serve with compassion. Be the difference.

Responsibilities

This role is responsible for the accurate and timely follow-up on billed accounts receivable, focusing on variances, non-payments, and denials across all payers. The representative must pursue identified payer variances, work with internal departments to resolve issues like missing payments or technical denials, and ensure accounts move toward resolution.