Job Title: Account Representative
Location: Bellaire, TX 77401 (Onsite)
Duration: 3 Months (Extension Possible)
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, work queue, 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.
- Professional claims experience is preferable
- Epic experience is preferable
- Government payer experience is preferable but not required if commercial payer is their only experience.
- Professional Claims
- Epic
- Knowledge of government, commercial, and managed care reimbursement methodologies
- Understanding of federal, state, and local aspects of collection regulations
Denials Management/Collections - Ability to work independently
- Critical Thinking Skills
- Oral/Written Communication Skills
- Technical skills (using payer portals, soft phones, e-fax, etc.)
- Microsoft Office (Outlook, Teams, Word, Excel)
- Time Management skills
Education:
High School Diploma – Required
2 years revenue cycle experience – Required