Job Description
Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).
The AR 3 Representative position is responsible for assisting patients with financial aspects of their hospital service and collecting outstanding balances. In this position, the candidate will also be expected to fulfill the role of mentor to both existing and newly hired patient account representatives on their team. The Senior Commercial PAR Representative will report directly to his/her supervisor and should have the required skills that will enable them to fulfill the role of acting supervisor in the supervisor’s absence. The ideal candidate must have 5 or more years of experience in the healthcare reimbursement industry primarily working with both Commercial insurance and Managed Care carriers. The Senior Commercial PAR Representative must also possess a strong knowledge and understanding of all line of business contracts.
Position Objectives:
Increase revenue for our client base by efficient account receivable follow-up and resolution.
Essential Duties & Responsibilities:
- Assist supervisor with the coordination and follow up of all claims from billing through final resolution.
- Assist the team in the review and preparation of claims for manual and/or electronic billing submission.
- Identify billing errors that require correction before it can be resubmitted to the payer. Educate your coworkers on why the error exists and help them understand what needs to be done to avoid repeat errors.
- Assist the supervisor with the review of electronic billing system edits that are prohibiting the claim from moving through the system cleanly.
- Work assigned accounts on a daily basis, according to project productivity and quality goals.
- Review and follow up with the team on any payment errors, low reimbursement, appeals, denials, etc. that may need the Senior Commercial PAR’s expertise for resolution.
- When needed, assist with the development of training documentation for new hires and established staff.
- Create and maintain a supportive relationship with management and clients.
- Communicate effectively with other departments within the company on client or payer changes that may impact their respective area.
- Create an environment whereby the team feels comfortable coming to you with their work questions prior to going to the supervisor.
- Keep current with all commercial and managed care pricing models, rules and regulations(including Medicare and Medicaid HMOs and managed care pricing models, rules and regulations
- Maintain a strong knowledge and understanding of all commercial payers within their specific project. (Including Medicare and Medicaid HMOs within their specific project.
- Maintain a professional attitude.
- Maintain confidentiality at all times.
Internal Responsibilities:
- Adheres to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time. Adheres to all applicable laws and regulations and the company's governance/compliance program.
- Responsible for reporting violations of the company's policies and procedures, Standards of Business Conduct, governance program, laws and regulations through the company's Help Line or other mechanism that may be available at the time of the violation. Assists with internal control failure remediation efforts.
- Becomes knowledgeable of internal control responsibilities through training and instruction. Responsible and accountable for internal control performance within their area of responsibility. Participates in the internal controls self-assessment process.
- Ensures concerns with internal control design or performance and process changes that impact internal control execution are communicated to management.
Minimum Qualifications & Competencies:
- 5 years’ experience in healthcare customer service or insurance collections field.
- Strong knowledge of computer billing systems, especially X-claim.
- Ability to train, mentor and lead a team.
- Experience working with customer support/client issue resolution management.
- Proficiency with MS Office
- Excellent oral and written communication skills.
Job/Functional Knowledge
Understands duties and responsibilities, has necessary functional and technical knowledge for task completion, keeps job knowledge current, applies knowledge and skills that lead to success in the job.
- Effectively applies background & experience to current role
- Demonstrates a comprehensive knowledge of particular field
- Keeps informed of latest trends, developments, and best and current practices in particular field
Customer Focus
Builds customer confidence, is committed to increasing customer satisfaction, sets achievable customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met, solicits opinions and ideas from customers. This competency applies to both external and internal customers.
- Uses first-hand customer feedback for improvements in products and services
- Establishes and maintains effective relationships with customers and gains their trust and respect
- Exceptionally responsive to customer needs and requests
Culture Fit
Demonstrates integrity and ethics in day-to-day tasks and decision making, adheres to MedAssets’ core values of compassion, commitment, character, and confidence, operates effectively in the MedAssets environment and the environment of the work group, maintains a focus on self development and seeks out continuous feedback and learning opportunities.
- Sincerely passionate for and committed to the mission of MedAssets
- Exhibits integrity in all actions and communication
- Works well autonomously, while acting as a team-player
- Demonstrates a vested interest in self-development
Travel: Minimal travel maybe required
Physical Demands:
The physical demands and work environment characteristics described here are representative of those that an employee must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. The employee must occasionally lift and/or move up to 15 pounds.
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Mental Demands: the employee must be able to follow directions, to get along with others, and handle stress;
- Work environment: The noise level in the work environment is usually minimal
Pay Transparency Disclaimer*
Savista is required by state-specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is $23.00 -$26.00 per hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.
SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
California Job Candidate Notice
Originally posted on Himalayas
