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Sr. Patient Account Specialist

Peyton Resource Group

Houston, TX

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JOB DETAILS
SKILLS
Accounts Receivable, Analysis Skills, Billing, Centers for Medicare and Medicaid Services (CMS), Claims Processing, Collections Regulations, Communication Skills, Content Management Systems (CMS), Credit and Collections, Customer Relations, Customer Support/Service, Denials Management, Documentation, Federal Laws and Regulations, Government, Healthcare, Hospital, Insurance, Insurance Claims, Maintain Compliance, Medicaid, Medical Billing, Medical Office Administration, Medicare, Microsoft Excel, Microsoft Office, Microsoft Word, Organizational Skills, Realtime Transport Protocol, Reconciliation, Regulations, Reimbursement, Reimbursement Guidelines, Resolve Customer Issues, State Laws and Regulations, Third-Party Payer, Time Management
LOCATION
Houston, TX
POSTED
6 days ago

Position Summary

We are seeking an experienced Patient Account Specialist Lead to support medical collections and revenue cycle operations for healthcare accounts. This role is responsible for resolving outstanding patient accounts, managing collection activities, and ensuring compliance with healthcare billing and collection regulations.

The ideal candidate will have a strong background in medical collections, Medicare billing, hospital A/R, and government insurance follow-up, along with excellent communication and analytical skills. This position interacts with patients, insurance carriers, internal teams, and external partners to drive timely account resolution and maximize recoveries.

Key Responsibilities

Medical Collections & Account Resolution
  • Manage and resolve assigned patient accounts through effective collection activities and follow-up efforts
  • Perform collections on government and third-party payer accounts while adhering to all applicable state and federal regulations
  • Ensure accurate and timely documentation of account activity within collection systems
  • Handle inbound calls from patients, insurance carriers, and external partners professionally and efficiently
  • Research and resolve account discrepancies, denials, payment variances, and claim issues
  • Validate claim payments to ensure reimbursement aligns with contract and payment methodology guidelines
  • Meet or exceed established productivity, quality, and recovery goals

Government Insurance & Medicare Support
  • Maintain working knowledge of Medicare/Medicaid billing, collections, appeals, and reimbursement guidelines
  • Process Medicare Redeterminations, Reopenings, and Reconsiderations as needed
  • Correct claims in RTP status according to Medicare guidelines
  • Support recovery audit and appeals processes related to government insurance claims
  • Research and reference CMS and Medicare regulations when resolving account issues

Collaboration & Customer Service
  • Partner with internal departments to obtain documentation needed for appeals and claim resolution
  • Promote positive patient and client relationships through professional and respectful communication
  • Ensure compliance with organizational policies and healthcare industry regulations
  • Assist with special projects and operational initiatives as assigned

Qualifications

Required Experience
  • 5–7 years of experience in:
    • Medical collections
    • Healthcare revenue cycle
    • Hospital accounts receivable (A/R)
    • Government insurance follow-up
  • Experience with Medicare billing processes and appeals

Preferred Background
  • Previous experience with:
    • Medicare/Medicaid collections
    • Recovery Audit Contractor (RAC) processes
    • Insurance claims processing
    • Healthcare billing systems and collections software

Technical Skills
  • Strong understanding of:
    • CMS regulations
    • Medical billing and reimbursement practices
    • Appeals and denials management
  • Proficiency with Microsoft Office, including Word and Excel
  • Strong analytical, organizational, and communication skills

Education
  • College coursework, healthcare billing certification/training, or insurance claims experience may be considered in lieu of direct hospital experience

About the Company

P

Peyton Resource Group

Established in 2001, Peyton Resource Group is a solution-based staffing company that matches businesses with top talent for short-term, long-term or permanent needs. People are a business’s most valuable asset. Peyton Resource Group is dedicated to helping companies find the best talent, matching professionals with jobs where they will thrive. With locations in Dallas/Fort Worth, San Antonio and Austin, we are available to serve your staffing needs throughout Texas and across the country.
COMPANY SIZE
100 to 499 employees
INDUSTRY
Staffing/Employment Agencies
WEBSITE
https://www.prg-usa.com/