[Hiring] Patient Account Representative II @Texas Health Resources

Role Description

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

Work Location: Texas Health Corporate, 612 E. Lamar Blvd., Arlington, TX 76011

Work Hours: Remote: Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion)

What You Will Do

• Receivables Management 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 needed to acquire and provide information needed for claims that have a zero payment.
• Use payor-specific contract terms to resolve claims that are in process or have a payment variance.
• Refer claims that have a clinical denial to the Denials team for review and follow-up.
• Prepare appeal letters to dispute payor denials when appropriate.
• Process &/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.
• Accounts should be worked daily, with an emphasis on quality and resolution.
• Worklists should be stratified to ensure high dollar and/or aged accounts are the top priority, with the overall goal of resolving assigned inventory each week.
• Works toward department goals and visions as an individual and as a team player.
• Meet, and maintain, quality and productivity performance metrics set forth by applicable leadership.
• Maintain proficiency in the host system.

Receivables Management related to Financial Assistance PAR II

• Review financial assistance application for completion prior to processing.
• Determine if application is complete. If incomplete, request additional documents from consumer by phone, mail, or email following HIPAA privacy guidelines.
• Document receipt of application in system and create a Case in Financial Assistance Module.
• Use appropriate activity code in Epic to ensure productivity is accurate.
• Review incoming applications received by mail, email or MyChart, to determine if all the required information was submitted.
• If incomplete, request additional documents from consumer by phone, mail, or email following federal HIPAA regulations.
• Process accounts timely, according to age, and consumer request.
• Prepare and mail all approval/denial letters.
• Prepare documents for scanning, removing non-essential information from packets to protect consumers' financial information.

Focus on Service

• Provide excellent service when dealing with payors, patients, employers, management, hospital staff and other parties within and outside of THR.
• Communication should be clear, concise, and professional.
• Requests should be addressed timely, with the goal of completion within 3 days to avoid delinquency.
• Requests deemed as "escalated" should receive immediate attention.

Payor Issues

• Identify and resolve problems related to payor contracts and reimbursement in a timely manner.
• Inform Business Operations Supervisor, Manager and/or Payor Champion of any potential trends that might delay accurate payment.
• Recommend accounts for placement with an outside collection/legal vendor when appropriate resolution is not obtained timely.

Compliance

• Compliance with THR policies and procedures.
• Complies with all applicable regulations with the operating systems, entity, and system policies and procedures.
• Complete assigned tasks in a timely and effective manner.
• Maintain up-to-date knowledge of local, state, and federal guidelines for communication and collections.

Qualifications

• H.S. Diploma or Equivalent Required
• 2 Years Healthcare Revenue Cycle Accounts Receivable Experience, healthcare or related organization Required
• Hospital collections experience Preferred
• Managed Medicare experience Preferred

Skills

• Computer skills required in advanced word processing, spreadsheets, and graphic skills.
• Ability to organize and coordinate workflow as well as meeting deadlines.
• Must possess excellent communication, problem solving documentation, training and customer service skills.
• Must be familiar with organizing, managing workflow and ability to absorb and retain details.
• General knowledge of medical and insurance terminology required.
• Experience in Epic preferred.

Supervision

• Individual Contributor

ADA Requirements

• Extreme Heat 1-33%
• Extreme Cold 1-33%
• Extreme Swings in Temperature 1-33%
• Extreme Noise 1-33%
• Working Outdoors 1-33%
• Working Indoors 67% or more
• Mechanical Hazards 34-66%
• Electrical Hazards 1-33%
• Explosive Hazards 1-33%
• Fume/Odor Hazards 1-33%
• Dust/Mites Hazards 1-33%
• Chemical Hazards 1-33%
• Toxic Waste Hazards 1-33%
• Radiation Hazards 34-66%
• Wet Hazards 1-33%
• Heights 1-33%
• Other Conditions 1-33%

Physical Demands

• Sedentary