Position Summary:

The patient account representative is responsible for the timely collection of third party and private pay receivables within regulatory guidelines.

The Patient Account Representative II role centers on the back-end functions of the revenue cycle, covering the full spectrum of patient accounting services. It places a strong emphasis on insurance follow-up and denials resolution as core areas of specialization.

• Manages account resolution related to insurance follow-up and denials management
• Overseas back-end revenue cycle functions from discharge through final account resolution
• Coordinates with payers to resolve outstanding claims and ensure timely reimbursement
• Specializes in identifying, tracking, and resolving claim denials to reduce delays and prevent revenue loss
• Location: Remote (2- 4 weeks onsite for training, 1851 Crosspoint Ave, 77054) Must be able to attend any required onsite meetings
• Must live in Texas (TX). This is a Remote position, and you must reside in Texas
  • **We DO NOT provide lodging or mileage reimbursement for training**

Position Key Accountabilities:

1. Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls in order to ensure prompt payment of medical claims.
2. Reviews incoming correspondence and takes appropriate action. Responds promptly to inquiries.
3. Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments.
4. Pursues appeals and takes the necessary steps to bring accounts to resolution.
5. Analyzes accounts for errors, adjustments and credits, issuing corrected entries when necessary. Updates account information accordingly.
6. Communication documentation demonstrates clear action taken on each account as well as what further action is needed to capture payment. Work output is documented clearly, so that various departments involved in resolution can review the account.
7. Ability to meet departmental standard for quality and productivity.
8. Other duties as assigned.

Certification/Skills:

Basic knowledge of business office, patient billing, or collection/ reimbursement procedures in a healthcare setting; proficient in MS Office with emphasis in Excel, 10-key and math.

Minimum Education:

High School Diploma or equivalent

Minimum Experience:

Three years hospital/ medical collections experience with understanding of third party reimbursement procedures, as well as state and federal regulations governing healthcare.

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:
This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.
Residency Requirement:

Employees must permanently reside and work in the State of Texas.