Patient Accounts Associate - Collections

Software Guidance & Assistance, Inc., (SGA), is searching for a Patient Accounts Associate - Collections for a Contract assignment with one of our premier Healthcare clients in Durham, NC.

Responsibilities :
Responsible for performing the reimbursement functions of billing and collections through evaluation, documentation and obtaining any information required to insure complete accuracy in creating a claim and collecting from a pay source. The Patient Account Associate position can also function in the roll for cash application and the responsibilities tied to this function. This position must be able to work independently to process complex patient medical claims by therapy and payer specifications to assure accurate and timely claim submission and follow up through final payment and cash posting.

• Insures confidentiality of patient information through HIPAA Compliance.
• Maintains knowledge base on changes to reimbursement, including but not limited to specific managed care contracts, Medicare/Medicaid guidelines, and third party insurance payers.
• Initiates appropriately timed correspondence and telephone contact to clarify and explain account or coverage situation with patients or guarantors, employers, insurance companies, and sponsoring agencies; obtains cooperation toward settlement of account.
• Maintains accountability for the prompt processing of claims including billing, claims transmission, and the collection of those claims, for a set group of accounts assigned.
• Obtains and follows up on all documentation needed in order to bill.
• Notifies supervisor and data manager regarding any medical documentation requested by payer sources, or patients.
• Investigates denials from insurance companies to insure claim resolution.
• Prioritizes accounts to maximize dollars in collections.
• Notifies supervisor of problem accounts and/or clinical issues that need to be addressed related to billing and collections.
• Researches and resolves delinquent accounts to insure timely collections and reduce DSO.
• Clearly notates databases as specified by supervisor.
• Submits appropriate documentation for adjustments, write-offs, refunds or bad debt to the appropriate Supervisor, Accounts Receivable.
• Communicates to supervisor any IT issues.
• If Patient Account Associate is assigned to the cash application function, that party accurately and efficiently performs all duties related to the cash application function as outlined by supervisor.
• Performs special projects as assigned and other duties as requested.

Required Skills:

• High School Diploma/GED
• 2+ years experience working in hospital access, physician office or billing and collections or an equivalent combination of relevant education and/or experience. A general knowledge related to government payer regulations and third party payer guidelines is helpful.
• Medical collections experience and calling insurance companies, and submitting claims
• Understanding of medical terminology, coding, third party benefits, government payer regulations, collection techniques, and cash management experience, is preferred.
• Must be computer literate. Excel experience is a plus.

SGA is a technology and resource solutions provider driven to stand out. We are a women-owned business. Our mission: to solve big IT problems with a more personal, boutique approach. Each year, we match consultants like you to more than 1,000 engagements. When we say let's work better together, we mean it. You'll join a diverse team built on these core values: customer service, employee development, and quality and integrity in everything we do. Be yourself, love what you do and find your passion at work. Please find us at .

SGA is an Equal Opportunity Employer and does not discriminate on the basis of Race, Color, Sex, Sexual Orientation, Gender Identity, Religion, National Origin, Disability, Veteran Status, Age, Marital Status, Pregnancy, Genetic Information, or Other Legally Protected Status. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, and our services, programs, and activities. Please visit our company to request an accommodation or assistance regarding our policy.