Providence Health & Services Specialist, Post-Acute AR in Orange, California
Providence St. Joseph Health is calling a Specialist, Post-Acute AR (Full-Time, Days) to our location in Anaheim, CA.
We are seeking a Specialist, Post-Acute AR who will be is responsible for the timely and accurate billing and collections of payments from insurance carriers, agencies and others for equipment and services provided by Providence Senior and Community Services and Home and Community Services which could include the following service lines of Home Infusion/Specialty Pharmacy/Oral Dose, Skilled Nursing Facility, Home Health, Hospice, and Home Medical Equipment.
The incumbent performs all duties in a manner that promotes Providence St. Joseph mission, values, and philosophy. In all aspects, this leader serves as a role model for the values and mission of the organization.
In this position you will have the following responsibilities:
Demonstrates competency in identifying and providing feedback regarding billing needs, recommending and implementing creative solutions to meet those needs, consistent with available resources, appropriate procedures, and internal controls for new and existing systems and coordinating efforts with other team members and departments.
Coordinates contacts with all third party representatives and others as required resolving issues related to outstanding claims.
Maintains knowledge of Medicare, Medicaid, and commercial payors rules and regulations by attending online seminars as directed by management and monitoring web sites to maintain regulatory compliance knowledge.
Maintains patient accounts by posting charges, cash receipts and adjustments. Assists accountants in balancing specific general ledger accounts as they relate to receivables, and cash receipts. May prepare and pursue collection on delinquent accounts.
Maintains and/or notify appropriate personnel of all appropriate schedules needed to bill efficiently. May assist in planning for new or upgraded financial systems and coordinates the implementation process among the finance users, information services staff and other parties.
May assist with preparation of financial reports for leadership, including credit balance reports for submission to Financial Intermediaries (FI) on a quarterly basis.
Retains and maintains all third party contract rates and associated billing codes to ensure maximum reimbursement to facility/agency.
Insures all appropriate regulatory requirements, including HIPAA, are incorporated into work practices in an effort to maintain regulatory compliance and promote the integrity of confidential/private data and patient information.
Maintains updated job standards list for assigned duties including detailed list of scheduled activities, deadlines, and order of completion to ensure coordination of workloads, volumes, staff changes and cross training.
Seeks out guidance when uncertain of a procedure, policy or standard operating practice and performs other duties as assigned.
Identifies process breakdowns as they occur, and remedies them or escalates them to a higher level
This position acts as a resource to others within Providence Senior and Community Services and as such, does not routinely delegate tasks. The position does coordinate the monthly financial close and some billing research activities with the Financial Services Department. Examples include notification to accounting that accounts receivable monthly close is complete, preparation of accounts receivable journal entries, or research of bad debts and/or patient accounts.
Key understanding of payment methodologies including, but not limited to, per diem billing, fee for service, resource utilization grouping, and Home Health episodic Perspective Payment System.
Ability to use pc based programs (Excel, Word and Outlook), automated billing systems, claim management software, fax, copier, printer, multi-phone line.
Other duties and responsibilities as assigned.
Required qualifications for this position include:
H.S. Diploma or GED or equivalent education/experience.
Minimum of two (2) years recent experience in a healthcare environment with an emphasis on reimbursement and collections.
Must have knowledge and experience with insurance contracts and/or Medicare/Medicaid Regulations.
Preferred qualifications for this position include:
College level courses in medical front office/medical billing.
About the department you will serve:
One Revenue Cycle (ORC) is the name adopted to reflect the Providence employees who work throughout Providence in revenue cycle systems and structures in support of our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. 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): California-Torrance, California-Orange
Req ID: 291081