Assist in managing the company’s outstanding receivables by communicating regularly with payers, including commercial insurance, Medicare, and private pay patients, to ensure patient care reimbursement is processed timely and paid accurately.
Key responsibilities include:
- Following up on submitted claims through all stages, including receipt, pending, processing, and payment
- Communicating with payers about delinquent or denied claims and removing barriers to payment
- Reviewing claim details to verify accurate reimbursement and initiating adjustments or appeals when needed
- Filing and following up on appeals for denied claims until resolution
- Maintaining outstanding patient balances and supporting accurate accounts receivable reporting
- Using online and phone resources to verify benefits and confirm proper claim processing
- Submitting refund requests when necessary
- Completing special projects assigned by leadership
- Meeting productivity and accuracy goals, including days in AR and cash collections
- Attending required meetings and performing additional duties as assigned
- Working overtime when needed
Requirements & Qualifications
Required qualifications include:
- High school diploma or GED
- At least 2 years of experience in a provider setting, either inpatient or outpatient
- Knowledge of payer insurance processes, including self-pay after insurance, reimbursements, collections, appeals, claims follow-up, and third-party billing
- Experience with medical records or patient accounting systems
- Understanding of state and federal payment laws
- Knowledge of explanation of benefits (EOBs)
- Experience using a 10-key adding machine
- Fluency in English, with strong written and oral communication skills
Location
Houston, Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
3 weeks ago