Job Title: Account Representative (37285543)
Job Location: Bellaire, TX 77401
Job Duration: 3 Months – Contract
Shift: Please note, while this is mostly a remote position, training will take place in office for up to 8 weeks.
Day Shift - Remote with residence in Houston area so that they are able to come to office for training and as needed.
Duties:
- Initiates calls or online web contact to payors or guarantors to verify receipt of claims/statements and collect on
outstanding accounts receivables as specified by current collection policies and procedures
- Documents follow-up activities, conversations with payors/guarantors, information obtained via the web contact, and any
correspondence in the account notes.
- Ensures payments received by third party payors are correct and the correct contractual discounts/allowances have been
applied according to the contract matrix or government reimbursement rates. Ensures that all accounts associated with
that guarantor and payor relationship are resolved.
- Analyzes and assesses accounts for outstanding balances and makes prudent decisions on appropriate actions needed to
resolve the balance.
- Identifies and reports inaccurate reimbursement and contractual trends to Sr. Reps, Team Lead, or Manager.
- Refers problem accounts to Sr. Rep, Team Lead or Manager prior to accounts becoming 60 days old. Documents the issues
in detail and refers to Sr. Rep, Team Lead or Manager with a recommendation of action needed. Provides continual
follow-up.
- Assists with special projects to ensure that collection, workqueue, and departmental goals are met.
Skills:
- General knowledge of government, commercial and managed care reimbursement methodologies and understanding of all
federal, state, and local legal aspects of collection regulations.
- The knowledge of how managed care plans work and the requirements for insurance coverage and benefits.
- Ability to communicate effectively both oral and written, good interpersonal skills; decision-making skills; professional
courtesy; the ability to operate a PC and general office equipment.
- Account Representatives must have a strong math aptitude in order to be able to verify the appropriate reimbursement
based upon the contract terms, benefits and/or government regulations.
EPIC experience, payer policy review, appeals, denials management, time management, ability to work independently
- Experience in physician services denials management. Specifically, researching payer trends, submitting appeals, tracking denials.
- Training = in-person; remaining is 90% remote. Training = Bellaire office; remaining remote (remote location requires quite location at home where PHI can be protected) Epic (PB), excel, outlook, Availity
- Physician Revenue Cycle and Insurance Collections experience with commercial payers – i.e BCBS, UHC, Cigna, and Aetna – is required.
- This includes appealing insurance claim denials, underpayments, and understanding root cause analysis of insurance related activities. Billing and general pediatric facilities experience is a PLUS.
- Experience with larger facilities and have a track record of being able to adapt to both quality and productivity standards.
- Applicants who do not have physician insurance collections experience and a minimum of 2 years of current job history will not be considered.
- Experience with Excel and Epic is strongly preferred.
Education:
High School Diploma-Required 2 years revenue cycle experience Required
Skills Required:
MEDICAL COLLECTIONS
Pay: $22.00 - $24.00 per hour
Application Question(s):
- If interested, please leave your email, contact number and best time to reach you
Experience:
- Revenue cycle management: 2 years (Preferred)
- Medical collections: 2 years (Preferred)
- EPIC , payer policy review, appeals, denials management: 2 years (Preferred)
Work Location: Hybrid remote in Bellaire, TX 77401
