• Job Description

  Req#: 481446WD

  Line of Service

  Advisory

  Industry/Sector

  Not Applicable

  Specialism

  Managed Services

  Management Level

  Associate

  Job Description & Summary

  A career in our Managed Services team will provide you an opportunity to collaborate with a wide array of teams to help our clients implement and operate new capabilities, achieve operational efficiencies, and harness the power of technology.
  
  Our Virtual Business Office team will provide you with the opportunity to act as an extension of our healthcare clients' business office. We specialize in revenue cycle functions and remediating aged 3rd party accounts receivable for hospitals, medical groups, and other providers. We leverage our custom and automated workflow and quality assurance products to enable our clients to achieve better results, which ultimately allow them to provide better patient care.

  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 a purpose-led and values-driven leader at every level. 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.

  As a Associate, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:

  • 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 1 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 relationshipsContributes 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

  • Additional Job Description

  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

  Optional Skills

  Desired Languages (If blank, desired languages not specified)

  Travel Requirements

  Not Specified

  Available for Work Visa Sponsorship?

  No

  Government Clearance Required?

  No

  Job Posting End Date

• About the company

  PricewaterhouseCoopers is a multinational professional services network of firms headquartered in London, United Kingdom, operating as partnerships under the PwC brand.

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