PATIENT ACCOUNT SPECIALIST LEAD

LOCATION: Houston, TX 77092 | Onsite

COMPENSATION & SCHEDULE

• Pay Rate: $20.32–$21.77 per hour

• Schedule: Monday–Friday, 8:00 AM–5:00 PM

• Employment Type: Full-Time, Temporary-to-Permanent (Temp-to-Perm)

• Start Date: ASAP 

ROLE IMPACT

The Patient Account Specialist Lead supports healthcare revenue cycle operations by managing medical collections, Medicare billing, and accounts receivable (A/R) follow-up. This position focuses on recovering outstanding balances, resolving insurance claim discrepancies, and ensuring compliance with Medicare, Medicaid, and federal and state collection regulations. Success requires extensive healthcare collections experience, strong knowledge of government insurance reimbursement, and consistent achievement of collection and productivity goals.

KEY RESPONSIBILITIES

• Manage medical collections for active accounts receivable (A/R) and bad debt (BD) accounts, ensuring timely recovery of outstanding patient and insurance balances.

• Process Medicare and Medicaid claims, investigate unpaid or denied claims, and initiate Medicare Redeterminations, Reopenings, and Reconsiderations as appropriate.

• Research billing discrepancies, validate insurance payments against contractual reimbursement guidelines, and coordinate with internal departments to resolve claim processing delays.

• Handle inbound patient and insurance carrier calls, resolve account inquiries, maintain accurate collection documentation, and provide professional customer service.

• Monitor collection activities, maintain compliance with CMS, Medicare, and applicable collection regulations, and consistently meet productivity, quality, and recovery standards.

MINIMUM QUALIFICATIONS

• 5–7 years of experience in healthcare billing, medical collections, hospital accounts receivable (A/R), insurance claims follow-up, or revenue cycle operations required.

• Direct experience with Medicare billing, government insurance collections, claim denials, appeals, and reimbursement processes required, including knowledge of Medicare/Medicaid guidelines and CMS regulations.

• Strong knowledge of hospital A/R processes, medical collection regulations, and insurance payment methodologies, with proficiency in Microsoft Word, Excel, and healthcare collection management systems.

CORE TOOLS & SYSTEMS

• Medicare/Medicaid Billing and Claims Processing Systems

• CMS Medicare Regulations and Reimbursement Guidelines

• Medicare Recovery Audit Contractor (RAC) Processes

• CCSM and DDe – Medicare claim correction and processing

• Healthcare Revenue Cycle Management (RCM) and Accounts Receivable (A/R) Systems

• Medical Collection Management Software

• Microsoft Word and Excel

PREFERRED SKILLS

• College education, healthcare billing trade school training, or previous insurance company claims experience.

• Experience with Medicare Redeterminations, Reopenings, Reconsiderations, and Recovery Audit Contractor (RAC) processes.

• Strong analytical, account resolution, communication, and organizational skills with the ability to meet collection and productivity goals.

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