About the job

Line of Service

 

Advisory

 

Industry/Sector

 

Not Applicable

 

Specialism

 

Managed Services

 

Management Level

 

Associate

 

Job Description & Summary

 

A career in our Advisory Acceleration Centre is the natural extension of PwC’s leading class global delivery capabilities. We provide premium, cost effective, high quality services that support process quality and delivery capability in support for client engagements.

 

To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be an authentic and inclusive leader, at all grades/levels and in all lines of service. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.

 

PwC Professional Skills And Responsibilities For This Management Level Include But Are Not Limited To

 

As an Associate, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution.

 

• Possesses thorough understanding of the hospital revenue cycle with specialization in hospital billing, follow-up, and the account resolution process to include, but not limited to: claims submission, acceptance, and adjudication, transaction reviews, adjustment posting, identification of patient responsibility, etc.
• Utilizes and applies industry knowledge to resolve aged accounts receivable by working various account types including, but not limited to: hospital and/or professional claims, governmental and/or non-governmental claims, denied claims, high priority accounts, etc.
• Leverages available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolution; documents all activity in accordance with organization and client policies
• Assists in mentoring of new hires including, but not limited, to shadowing and answering general collection questions
• Remains open-minded with change: maintains performance during period(s) of change and understands changes in tasks and/or environment as well as the basis for change
• Possesses ability to professionally communicate (in all forms) with payer resources such as: website, e-mail, telephone, customer service departments, etc.
• Possesses a cooperative and positive attitude toward clients, management and co-workers by responding politely and professionally and being a valued team player

 

The primary purpose of this position is to work accounts to full resolution – i.e., through payment, adjustment,

 

identification of patient responsibility, and/or client-specified point of return. The Patient Accounting Specialist

 

resolves accounts and/or performs a secondary review of specific account actions to validate accuracy,

 

completeness and appropriateness of actions taken to resolve accounts in adherence to client, organization,

 

regulatory policies and procedures. This position takes direction from the Team Lead and supports quality

 

account resolution.

 

Years Of Experience

 

• Minimum Years of Experience: 3+ years in a healthcare setting

 

Responsibilities

 

• Possesses thorough understanding of the hospital revenue cycle with specialization in hospital billing, follow-up, and the account resolution process to include, but not limited to: claims submission, acceptance, and adjudication, transaction reviews, adjustment posting, identification of patient responsibility, etc.
• Utilizes and applies industry knowledge to resolve aged accounts receivable by working various account types including, but not limited to: hospital and/or professional claims, governmental and/or non-governmental claims, denied claims, high priority accounts, etc.
• Leverages available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolution; documents all activity in accordance with organization and client policies
• Assists in mentoring of new hires including, but not limited, to shadowing and answering general collection questions
• Remains open-minded with change: maintains performance during period(s) of change and understands changes in tasks and/or environment as well as the basis for change
• Possesses ability to professionally communicate (in all forms) with payer resources such as: website, e-mail, telephone, customer service departments, etc.
• Possesses a cooperative and positive attitude toward clients, management and co-workers by responding politely and professionally and being a valued team player

 

Required Knowledge And Skills

 

• Minimum 3 year customer service experience required
• Strong written and oral communication skills
• Computer and internet literate in an MS Office environment
• Ability to establish and maintain effective working relationships Contributes to team success by establishing positive working environment; Understands team objectives and cooperates and collaborates with others to achieve them
• Focus on value creation and enhancement through process improvement and issues based problem solving
• Inventory management: conducts accurate research in an organized manner, questions basic inconsistencies in information reviewed, and raises to appropriate level
• Demonstrates an awareness of workloads; offers to help team members and/or team management; takes on additional tasks when appropriate
• Develops self and others through coaching
• US Healthcare Commercial and Managed Care Insurance Claim Management/Billing/Claim Edit Resolution
• US Healthcare Medicare and Medicaid Insurance Claim Management/Billing/Claim Edit Resolution
• US Healthcare Denials Management (technical and clinical)
• US Healthcare Underpayment/Payment Variance Management

 

Desired Knowledge / Skills

 

• Minimum 1 year medical collections, billing and/or claims experience preferred
• Minimum 1 year Medicare exposure preferred
• Epic Resolute, HB and PB Patient Accounting
• Cerner RevElate Patient Accounting
• Meditech Patient Accounting

 

Education (if blank, degree and/or field of study not specified)

 

Degrees/Field Of Study Required

 

Degrees/Field of Study preferred:

 

Certifications (if blank, certifications not specified)

 

Required Skills