Patient Account Representatives II

Overview

Bring your passion to Texas Health so we are Better + Together.

Experience In Epic Preferred

• Job Code:
• Position:
  Patient Account Representatives II
• Work Location:
  
  Remote – Texas Health Corporate, 612
  
  E. Lamar Blvd., Arlington, TX 76011
• Work Hours:
  
  Full Time Days (8:00am–5:00pm) for 40 hrs/week; remote work allowed at manager's discretion

• Receivables Management and Collections: verify validity of account balances by researching, reviewing, and ensuring accuracy of payment and adjustment posting.
• Takes initiative to resolve accounts with and without supervision.
• Contact payors, networks, patients, employers, and other responsible parties to acquire timely and accurate/expected payment on assigned Accounts Receivable inventory.
• Take necessary steps to acquire and provide information needed for claims with zero payment.
• Use payor-specific contract terms to resolve claims that are in process or have a payment variance.
• Refer clinical denial claims to the Denials team for review and follow-up.
• Prepare appeal letters to dispute payor denials when appropriate.
• Process and/or request rebills and other system actions as needed.
• Understand and apply appropriate system discounts.
• Enter all communications regarding patient accounts in the host system.
• Work accounts daily with emphasis on quality and resolution; stratify worklists to prioritize high-dollar and/or aged accounts with the goal of resolving assigned inventory each week.
• Contribute as an individual and team member to department goals and vision; meet and maintain quality and productivity metrics set by leadership; maintain proficiency in the host system.
• Receivables Management related to Financial Assistance PAR II’s: review financial assistance applications for completion and follow HIPAA guidelines when requesting additional documents; create a Case in the Financial Assistance Module using appropriate activity codes for productivity.
• Review incoming applications (mail, email, MyChart) to determine if all required information is submitted; request missing documents per HIPAA guidelines; process accounts timely according to age and requester; prepare and mail approval/denial letters; prepare documents for scanning and protect consumer financial information.
• Service responsibilities include providing excellent service to payors, patients, employers, management, hospital staff, and others; communicate clearly and professionally; address requests timely with a goal of completion within 3 days; escalate when necessary.
• Payor Issues: identify and resolve problems related to payor contracts and reimbursement; inform supervisors of potential trends that may delay payment; recommend accounts for placement with outside collection or legal vendors when timely resolution is not obtained.
• Compliance: adhere to THR policies and procedures; comply with regulations; complete tasks timely; stay up-to-date with local, state, and federal guidelines for communication and collections.

• Education:
  High School Diploma or Equivalent required.
• Experience: 2 years Healthcare Revenue Cycle Accounts Receivable experience in a healthcare or related organization required.
• Skills:
  Proficiency in word processing, spreadsheets, and graphic skills; ability to organize and coordinate workflow and meet deadlines; excellent communication, problem-solving, documentation, training, and customer service skills; familiarity with organizing, managing workflow, and retaining details; general knowledge of medical and insurance terminology.
• Experience In Epic Preferred
• Supervision:
  Individual Contributor

• ADA Requirements: various hazards and conditions described (Extreme Heat, Cold, Temperature Swings, Noise, Outdoors/Indoors, Mechanical, Electrical, Explosive, Fume/Odor, Dust/Mites, Chemical, Toxic Waste, Radiation, Wet, Heights) with varying percentages per category.
• Physical Demands:
  Sedentary