Providence Health & Services Associates Collections Representative in California
Providence St. Joseph is calling a Associates Collections Representative to our location in Lubbock, TX.
We are seeking a Associates Collections Representative who will be responsible for performing insurance liability collection and accounts receivable activities for commercial accounts (PPO, HMO, POS, Managed Medicare/Medicaid, Private, etc.) to ensure the timely receipt of insurance liabilities for hospital services. This individual follows up on accounts regularly to verify timely receipt of claim, check claim status, submit required documentation, and track overall claim processing. In addition, this individual identifies functional issues and barriers and reports them to the PFS manager.
In this position you will:
Complete and independently manage account follow-up based on preset follow-up guidelines defined by payor type and account balance:
Verify claim is received by commercial payor timely in accordance with the timely filing limits of the contractual agreement and/or state or federal regulations.
Monitor accounts receivable daily through worklists and check claim status through payor claims department or online to ensure proper claims processing.
Complete periodic payor phone calls to confirm claim status and drive claim resolution as dictated by department collections policies.
Document follow-up activity or pertinent notes (e.g., date of receipt, reference number) within the system of record to track and record overall claim process history.
Obtain and submit any necessary documentation to support claim processing if required by the contractual agreement, payor guidelines, or state or federal law.
Report any critical account issues or barriers in the collections process to the Co-Op PFS Manager.
Trend and document ongoing payor issues and notify PFS management.
Ensure that all activities related to hospital collection functions meet department requirements, maximize revenue collection, and achieve leading practice levels of performance.
Daily focus on attaining productivity standards, recommending new approaches for enhancing performance, and productivity when appropriate.
Assist Associate Collections Representative staff with daily account questions, issues, or barriers as necessary.
Act as a knowledgeable resource on commercial collections functions for department staff. (e.g., answer account questions, assist with new staff training, etc.).
Required qualifications for this position include:
- Experience in medical management computer applications
Preferred qualifications for this position include:
H.S. Diploma or GED
3 years Health care business office experience or related field
5 years Collections experience and medical terminology
About the department you will serve.
One Revenue Cycle (ORC) is the name adopted to reflect the Providence employees who work throughout Providence Health & Services (PH&S) in revenue cycle systems and structures in support of our ministries and operations in all regions from Alaska to California. ORC’s objective is to ensure our core strategy, One Ministry Committed to Excellence, is delivered along with the enhanced overall patient care experience (know me, care for me, ease my way) by providing a robust foundation of services, operational and technical support, and the sharing of comprehensive, relevant, and highly specialized revenue cycle expertise.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Billing/Insurance
Other Location(s): Montana, California, New Mexico, Oregon, Washington, Texas, Alaska
Req ID: 293727