Patient Account Representative Specialist Underpayment Recovery Full Time

Patient Account Representative Specialist Underpayment Recovery Full Time job in ,

Shift: Day
Schedule: Full - Time Regular


Patient Account Representative Specialist- Underpayment Recovery, Full-Time job, Days, Albuquerque, NM

We are looking for a Patient Account Representative Specialist to join our Underpayment team in Albuquerque, NM.
This full-time job is located with Lovelace Shared Services, organizational support departments for all Lovelace facilities including Coding, Finance, Health Information Management, Revenue Cycle, Marketing, and the Resource Team. We are dedicated to exceeding our customers’ expectations in every way.


Patient Account Representative Specialist Job Responsibilities:


  • Ability to prioritize and complete assignments in accordance with departmental policies and procedures with little to no supervision.
  • Responsible for successful claim payment within established accounts receivable key performance indicators.
  • Manage and reconciles accounts, update and document financial data, utilize excellent customer service skills to contact patients and insurance carriers to ensure accurate reimbursement in accordance with current payor contracts.
  • Utilize current technology, which may include web based products such as EPIC, SSI, Nthrive, RAC tracker, E.H.R., RTE, and payer portals.
  • Identify and resolve issues associated with claim underpayments
  • Contact designated insurance carriers to inquire on underpayment and send appeal letters to insurance carriers
  • Research contracts and esclate contract issues
  • Review Managed Care Contracts and compare against claims to identify discrepancies
  • Run worklists/reports to identify accoutns with variances
  • Works proejcts as identified by leadership
  • Maintains payer spreadsheets and joins payer calls and JOCs meetings
  • Needs to have knowledge of assigned payer contracts, processes, and issues
  • Negotiates with non contracted payers for payment


Patient Account Representative Specialist Education and Experience Requirements:

  • High School Diploma or GED, Associate’s Degree in Business or related field desired
  • Three (3) years of job-related experience preferably in in a Healthcare business environment. 
  • HFMA Certified Revenue Cycle Representative (CRCR) desired
  •   Knowledge of medical terminology and billing/collections practices; knowledge of payer edits, rejections, rules and how to appropriately respond to each
  •   Accuracy in identifying the cause of rejections/denials and selecting the most appropriate method for resolution
  •   Needs to have knowledge of assigned payer contracts, processes and issues.
  •   Demonstrates proficiency with timely and successful appeals to insurance companies
  •   Ability to demonstrate initiative, and time management skills
  •   Excellent analytical skills and problem-solving skills
  •   Multi task in a fast paced environment and handle overlapping commitments and deadlines

Why Lovelace?

  • Named one of the 150 Great Places to Work in Healthcare by Becker’s Hospital Review
  • Named one of the Best Places to Work by Albuquerque Business First
  • Named Top Workplace by Albuquerque Journal, 2013, 2014, and 2015
  • Named to Modern Healthcare’s 100 Best Places to Work five times since 2008

Lovelace is a drug-free employer with smoke free campuses.

  ID: 4537

Department / Location

Business Office
Ardent Patient Financial Services -