Account Representative - (Museum District)

Houston Methodist - Houston, TX

Full-time - Entry Level

Houston, TX

1,001-5,000 employees

Nursing and Residential Care Facilities

About the position

The Account Representative at Houston Methodist is responsible for resolving outstanding third-party insurance claims for professional services. This role involves performing collections activities on both simple and complex denials, as well as managing outstanding insurance balances. The position also focuses on identifying denial trends to prevent future issues and collaborating with various departments to enhance the revenue cycle process.

Responsibilities

• Resolve outstanding third-party primary and secondary insurance claims for professional services.
• Perform collections activities on simple and complex denials and outstanding insurance balances.
• Provide information regarding denial trends for future prevention.
• Collaborate with management to reduce aging of accounts through effective communication.
• Identify denial trends and notify supervisors to prevent future denials.
• Assist with knowledge sharing and cross-training among team members.
• Complete special projects to improve team performance as assigned.
• Demonstrate expertise in all payors, including Medicare, Medicaid, and commercial payors.
• Ensure compliance with HIPAA and PCI regulations.
• Review third-party payor work queues to locate and resolve accounts.
• Document clear and concise follow-up notes for each account worked.
• Meet and exceed established follow-up productivity goals.

Requirements

• High School diploma or equivalent education (GED, verification of homeschool equivalency, etc.).
• Three years of physician billing experience, preferably in a multi-specialty physician practice.
• In-depth knowledge of CPT-4, ICD-9, ICD-10, and HCPCS coding.
• Extensive knowledge of billing, collections, reimbursement, and the appeals process.
• Understanding of revenue cycle fundamentals and third-party payor reimbursement policies.

Nice-to-haves

• Ability to effectively communicate with patients, physicians, and co-workers.
• Excellent communication and negotiation skills.
• Proficient computer skills and ability to navigate multiple software programs.
• Ability to remain calm in stressful situations.

Benefits

• Full-time position with opportunities for professional development.