Senior Patient Account Specialist

$35,360 - $41,600/Yr

The Csi Companies Inc. Of Florida - Houston, TX

Full-time - Mid Level

Houston, TX

About the position

The Sr. Patient Account Specialist plays a crucial role in the healthcare sector by providing medical collection services for TLRA collection units. This position requires a strong background in medical collections to effectively resolve accounts, ensuring compliance with client, state, and federal guidelines. The specialist will engage in various collection activities, including follow-ups and account resolutions, while maintaining professional communication with patients, clients, and reimbursement vendors.

Responsibilities

• Utilizes and applies industry knowledge to resolve aged accounts receivable by working various account types including hospital and/or professional claims, governmental and/or non-governmental claims, denied claims, and high priority accounts.
• Manage multiple work queues for follow-up and denials by engaging payor websites and initiating calls to ensure prompt payment of medical claims.
• Pursues and/or follows up on appeals.
• Initiates communication with coding team and clinical staff when coding-related and medical necessity appeals are warranted.
• Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments.
• Makes recommendations for resolution.
• Remains open-minded with change and maintains performance during periods of change.
• Possesses ability to professionally communicate with payer resources such as websites, e-mail, telephone, and customer service departments.
• Possesses a cooperative and positive attitude toward clients, management, and co-workers, responding politely and professionally.
• Ability to meet departmental standards for quality and productivity.

Requirements

• Verifiable High School Diploma or equivalent.
• Minimum of 3 years' experience in a Customer Service call center environment with a focus on healthcare billing/collections or healthcare collection agency environment.
• General hospital A/R accounts knowledge is required, with a thorough understanding of the hospital revenue cycle, specializing in hospital billing, follow-up, and the account resolution process.
• Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred.
• Experience with Medicare & Medicaid billing processes and regulations preferred.
• Understanding of Medicare language.
• Knowledge in locating and referencing CMS and/or Medicare Regulations preferred.
• PC skills in a Windows environment are required, with solid knowledge and utilization of desktop applications including Word and Excel.

Benefits

• Weekly pay
• Medical, dental, and vision coverage
• Voluntary Life and AD&D coverage
• Paid Training
• Opportunity for advancement upon performance and availability