PFS A/R Rep

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine beauty of St. Tammany Parish adds to our attractive compensation package. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain. It is a peaceful, scenic, community-oriented area with an abundance of amenities to suit every taste. JOB DESCRIPTION AND POSITION REQUIREMENTS Scheduled Weekly Hours: 40 WORK SHIFT: (M-F) 8am - 4:30pm JOB SUMMARY: Responsible for all duties involved with the follow-up and prompt collections of inpatient and outpatient account balances; ensures that claims are adjudicated timely and appropriately for payment or denial by payers. Time frames are specific and must be adhered to so that reimbursement is received timely. Responsible for telephoning patients and/or insurance companies to resolve account balances. MINIMUM QUALIFICATIONS: High school diploma or equivalent Proficient computer skills, as well as all office equipment Ability to efficiently and effectively work with insurance companies, patients/patient representatives, and other STHS Departments Strong analytical and problem-solving skills Familiar with payment methodologies including fee schedules, per diems, case rates, case mix and carve outs Possess knowledge of current billing guidelines and can research via resources such as CMS website, MLN, LMRPs, payor websites, CCI editor, MUE editor Resolve both denial and discrepancy issues in claim payments by insurance payers Ability to communicate effectively and professionally, both verbally and in writing Use Microsoft Office in performance of duties and responsibilities Preferred Qualifications: 1 year insurance collections/follow-up experience preferred in a medical clinic, hospital facility, revenue cycle, registration, financial counseling, or other healthcare entity. Use of EPIC and/or nThrive billing systems. PHYSICAL DEMANDS: Must possess good physical health. Some requirements include but are not limited to standing, sitting or walking for long periods of time. Lifting at least 20 pounds is required. Physical Effort required: Constant (67%-100%) – talking, hearing, seeing Frequently (34%-66%) – NONE Occasionally (1%-33%) - lifting, carrying, pushing/pulling, climbing (stairs, ladders, poles, etc.), balancing, crouching, crawling, reaching, handling/feeling EMPLOYMENT Each St. Tammany Health System staff member is expected to conduct himself or herself according to our mission, vision and values. Please take time to review those expectations, which can be found by clicking here, before applying for employment. If you feel you are unable to demonstrate those characteristics, we respectfully request that you do not proceed with the application process. EQUAL OPPORTUNITY EMPLOYER St. Tammany Health System is an Equal Opportunity Employer. St. Tammany Health System is committed to equal employment opportunity for all employees and applicants without regard to race, color, religion, sex, age, national origin or ancestry, citizenship, sexual orientation, gender identity, veteran status, disability status, genetic information or any other protected characteristic under applicable law. St. Tammany Health System is a full-service acute care facility that delivers today’s life-improving procedures with the latest technology, highest quality and the utmost care to area residents. From wellness and prevention to diagnosis, treatment, rehabilitation and recovery, the St. Tammany Health System delivers the very latest technology, the most accomplished specialists and highly personalized, caring staff to ensure patients and their families receive world-class healthcare close to home. St. Tammany Health System is an independent service district in a clinically integrated partnership with Ochsner Health System. Together, the two organizations focus on aligning their healthcare offerings to best serve patients and families in west St. Tammany Parish and surrounding areas.