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Account Representative

Integrated Resources, Inc

Bellaire, TX(remote)

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JOB DETAILS
SKILLS
Accounts Receivable, Analysis Skills, Billing, Claims Processing, Collections Regulations, Communication Skills, Denials Management, Documentation, Epic Systems, Government, Government Contracts, Government Regulations, Health Plan, Healthcare, Healthcare Reimbursement, Insurance, Interpersonal Skills, Legal, Managed Care, Mathematics, Medical Billing, Microsoft Excel, Microsoft Outlook, Office Equipment, Pediatrics, Presentation/Verbal Skills, Reimbursement, Team Lead/Manager, Time Management, Trend Analysis, Work From Home, Writing Skills
LOCATION
Bellaire, TX
POSTED
25 days ago
Job Title: Account Representative
Location: Bellaire, TX 77401 (Remote after initial onsite training in Houston)
Duration: 3 Months (Extension Possible)

Description:
  • 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., Client, Health Care Company, Client, and Client - 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. Please note, while this is mostly a remote position, training will take place in office for up to 8 weeks. Remote positions require adherence to the Client s Telecommute policy.

About the Company

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Integrated Resources, Inc