2 Insurace Collector - Physician Billing (Medical Center) Jobs in Houston, TX

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Insurace Collector - Physician Billing (Medical Center)

Houston Methodist

Houston, TX | Full Time

$62k-82k (estimate)

1 Month Ago

Insurance Collector - Physician Billing (Medical Center)

Houston Methodist

Houston, TX | Full Time

$57k-75k (estimate)

0 Months Ago

Insurace Collector - Physician Billing (Medical Center)

$62k-82k (estimate)

Full Time | Ambulatory Healthcare Services 1 Month Ago

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Houston Methodist is Hiring an Insurace Collector - Physician Billing (Medical Center) Near Houston, TX

At Houston Methodist, the Account Representative position is responsible for resolving all outstanding third party primary and secondary insurance claims for professional services. This position performs collections activities on simple and complex denials and on outstanding insurance balances in the professional fee environment. This role is also responsible for providing information regarding denial trends for future prevention.

PEOPLE ESSENTIAL FUNCTIONS

Collaborates with management to reduce aging of accounts by providing verbal and written communication.

Identifies denial trends and notifies supervisor and/or manager to prevent future denials and further delay in payments. Collaborates with internal CBO departments and Account Managers to communicate and prevent denials. Provides suggestions for resolution.

Assists with knowledge sharing, payor and department cross training, and provides support to other team members as advised by the manager and/or supervisor.

SERVICE ESSENTIAL FUNCTIONS

Completes special projects to improve team performance, as assigned.

Demonstrates expertise of all payors, including Medicare, Medicaid and commercial payors, and applicable department's revenue cycle operations.

Ensures protection of private health and personal information. Adheres to all Health Insurance Portability and Accountability Act (HIPAA) and Payment Card Industry (PCI) compliance regulations.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

Reviews third party payor work queues to locate and resolve accounts. Resolves denials as they appear. Documents clear, concise and complete follow-up notes in system for each account worked. Assures accounts are completed and worked at a high level of quality by visually proofreading and monitoring work output.

Identifies, analyzes and escalates trends impacting accounts receivable (AR) collections.

Meets and/or exceeds established follow-up productivity goals.

FINANCE ESSENTIAL FUNCTIONS

Expedites and maximizes payment of insurance medical claims by contacting third party payors and patients. This includes making outbound calls to payors and accessing payor websites.

Reviews and assesses entire account to determine necessary steps or activity to resolve outstanding denials.

Performs appropriate billing functions, including claims resubmission to payors.

Creates and submits appeals when necessary. Engages the coding follow-up team for any medical necessity or coding related appeals.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

Stays current on collection procedures of various payors and industry trends. Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development.

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

EDUCATION

High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

WORK EXPERIENCE