Accounts Receivable, Analysis Skills, Claims Processing, Collections Regulations, Communication Skills, Documentation, Government, Government Contracts, Government Regulations, Health Plan, Healthcare Reimbursement, Interpersonal Skills, Legal, Managed Care, Mathematics, Office Equipment, Presentation/Verbal Skills, Reimbursement, Team Lead/Manager, Trend Analysis, Writing Skills
- Job Title: Account Representative
- Location: Bellaire, TX 77401 (On Site)
- Duration: 03 months, Contract
- Required: 2 years revenue cycle experience
- Scheduled Notes: Day Shift Remote with residence in Houston area so that they are able to come to office for training and as needed.
Job 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.
Required Skills and Experience:
" 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.
Preferred Skills and Experience:
Experience in physician services denials management.
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.e
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