Sr Patient Access Rep - Collections

About LCMC Health

We’re a New Orleans-based, non-profit health system on a mission: to provide the best possible care for every person and parish in Louisiana and beyond, and to put a little more heart and soul into healthcare along the way. And that means we do things a little differently around here.

Treating people like family is the LCMC Health way, and it always has been. Founded by Louisiana’s only freestanding children’s hospital, we’ve grown into a healthcare system that’s built to serve the unique needs of our communities and families.

Today, we offer five hospital locations: Children’s Hospital, Touro, University Medical Center New Orleans, New Orleans East Hospital, and West Jefferson Medical Center. We also offer a network of urgent care centers across the greater New Orleans area. With over 2,000 board-certified physicians specializing in everything from head to toe, our community can count on us to provide the right care, right where they need it.

This position has the potential to be remote after training.

osition Summary
The Senior Patient Account Rep CBO Operations-Collections is primarily responsible for ensuring the appropriate action is taken on assigned accounts in a timely manner resulting in positive resolution, as well as serving as a mentor and resource to fellow collection staff. As needed, this individual is also responsible for completing or assisting with special projects.

Principal Duties and Responsibilities

• Maintains responsibility for accurate and timely completion of daily follow-up or denial account assignment
• Identifies and analyzes underpayments to identify reasons for discrepancies and process denials and appeals as needed
• Reviews posted payments and adjustments to ensure accuracy. Analyzes EOBs to ensure proper reimbursement
• Conducts relevant research to complete appeals process to include assessing, complete and accurate documentation, tracking, responding to, and / or resolving appeals with third party payers in a timely manner
• Communicates with payers on outstanding claims, resolves payment variances and achieves timely reimbursement
• Collaborates with internal departments and external organizations to ensure correct reimbursement and resolve appeals
• Monitors underpaid and denied claims for trends and to identify root causes and reports findings to supervisor
• Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management
• Observes best practice processes in follow-up and customer service activities 


• Participates in staff training that aligns with recognized improvement opportunities and increase understanding of Medicare/Medicaid requirements as well as general follow-up processes
• Acts in accordance with LCMC’s mission and values, while serving as a role model for ethical behavior
• Adheres to federal and state regulations related to the protection of patient information (e.g., the Health Insurance Portability and Accountability Act (HIPAA) as well as facility-specific guidelines

The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.

Position Qualifications


Education

• A high school diploma or GED required; Bachelor’s degree preferred

Experience

• Minimum two years of experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management is preferred

Knowledge, Skills, Abilities

• Must be able to pass basic computer skills test and system level training
• Working knowledge of system reports and the ability to analyze system information to determine the impact of possible changes
• Demonstrates knowledge of:
• Hospital and professional billing processes and reimbursement
• Third-party contracting
• Insurance protocols, delay tactics, systems, and workflows
• ERISA guidelines for denials and appeals
• Regulations related to denials and appeals
• Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change
• Possesses efficient time-management skills and proven ability to multitask under tight deadlines
• Demonstrates excellent customer service skills
• Effective writing and communication skills
• Strong comfort level with computer systems

LCMC is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, disability status, protected veteran status, or any other characteristic protected by law.