Job Title: Commercial Patient Account Rep II
Job Location: Fountain Valley, CA 92708
Job Duration: 2 months with possible extensions
Shift : 40hrs/week

Job Description:
Commercial Patient Account Representative, II is responsible for all billing and/or collections of Commercial payor accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible. This position takes ownership of their accounts and eliminates barriers to ensure timely and correct payment including involvement with payors upper management, when necessary. This position will have working knowledge and understanding of Commercial managed care contracts including other complex payment methodologies to ensure prompt and accurate reimbursement. Complies with State and Federal statutes and regulations.

Essential Duties:

• Adheres to all confidentiality policies and procedures and carries out all tasks in a pleasant and respectful manner.
• Able to be at work and on time, follow organization rules and procedures and directions from a Coordinator/Lead or other member of the Management staff.
• Researches and responds to patient and/or Commercial insurance inquiries timely, effectively and according to policies and procedures resulting in resolution.
• At all times, provides professional and exceptional customer service when interacting with internal and external customers.
• Documents all communications in the financial system and updates demographics ensuring accuracy and appropriate information to move the account towards payment.
• Meets productivity goals as set by Management.
• -Reviews and processes Commercial insurance company refunds in the financial system by ensuring the refund amount is appropriate.
• Uses critical thinking skills to monitor and follow-up on Commercial payor claims to ensure correct hospital reimbursement in a timely and accurate manner.
• Demonstrates knowledge of Commercial payor hospital account management billing and collections skills.
• Demonstrates appropriate, aggressive telephone and/or online follow-up as necessary to expedite payment of billed charges with minimal supervision.
• Be at work and be on time.
• Follow company policies, procedures and directives.
• Interact in a positive and constructive manner.
• Prioritize and multitask.
• Other duties as assigned.

Required Skills & Experience:

• Minimum two (2) years’ experience and understanding of Commercial payor hospital collections processes.
• Excellent interpersonal skills.
• Positive work ethic.
• Written and verbal communication skills to meet productivity standards.
• Microsoft Office and Outlook experience.
• Ability to provide prompt and courteous customer service to all internal and external customers.
• Ability to use critical thinking to research, review and follow-up on all accounts.
• Ability to communicate effectively in verbal and written form.
• Ability to analyze documentation and resolve patient, billing and/or collection issues appropriately and timely.
• Ability to identify problems in a timely manner and initiate appropriate actions to resolve problems or issues.
• Ability to make suggestions for enhancements throughout the department and continually seeks opportunities to improve current policies, procedures and practices.
• Ability to recognize and perform essential duties and offers assistance to others or performs other required tasks when own assignments are completed.
• Ability to use critical thinking while reviewing billing and collection notes in the financial computer system to ensure that the appropriate action is taken within the billing and collection process and to ensure correct hospital reimbursement.

Preferred Skills & Experience:

• Use of 10-key calculator by touch.
• Bi-lingual.
• Knowledge of medical terminology and coding.

Required Education: High school diploma or GED.

Preferred Education: Associate’s degree or medical field certificate. 

About Us: SPECTRAFORCE is one of the fastest-growing workforce solutions firms in the United States. As a diversity-owned business, we place human connection at the heart of everything we do, building strong relationships with both clients and candidates to fill roles successfully. Our teams in North and Central America and India serve more than 150 Fortune clients globally, leveraging custom AI technology to provide direct hire, executive search, nearshoring, offshoring, and project staffing solutions.
 
Benefits: SPECTRAFORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRAFORCE provides unpaid leave as well as paid sick leave when required by law.

Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at LOA@spectraforce.com if you require reasonable accommodation.
 
California Applicant Notice: SPECTRAFORCE is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting NAHR@spectraforce.com.
 
LA County, CA Applicant Notice: If you are selected for this position with SPECTRAFORCE, your offer is contingent upon the satisfactory completion of several requirements, including but not limited to, a criminal background check. We consider qualified applicants with arrest or conviction records for employment in accordance with all local ordinances and state laws, including the Los Angeles County Fair Chance Ordinance for Employers (FCO) and the California Fair Chance Act (FCA). The background check assessment will consider whether a criminal history could reasonably have a direct, adverse impact on the job-related safety, security, trust, regulatory compliance, or suitability for this role. Such findings may result in withdrawal of a conditional job offer. 


At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $38.00/hr.