Patient Account Specialist Senior-Onsite

8974883 Patient Account Specialist Senior-Onsite, Houston, TX, 3 Months
Sigma Inc. is currently looking for a Patient Account Specialist Senior to work onsite with our team in Houston, TX.

Shift Timings: Monday-Friday

Summary:

• Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection.
• This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines.
• Patient and client satisfaction is essential.
• Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and Client inventory.
• Possesses a thorough understanding of the hospital revenue cycle with specialization in hospital billing, follow-up, and the account resolution process.
• Utilizes and applies industry knowledge to resolve aged accounts receivable by working various account types, including, but not limited to: hospital and/or professional claims, governmental and/or non-governmental claims, denied claims, high-priority accounts, etc.
• Manage multiple work queues for follow-up and denials by engaging payor websites and initiating calls in order to ensure prompt payment of medical claims.
• Pursues and/or follows up on appeals. Initiates communication with the coding team and clinical staff when coding-related and medical necessity appeals are warranted.
• Identifies denial trends and notifies the supervisor and/or manager to prevent future denials and further delay in payments.
• Makes recommendations for resolution.
• Remains open-minded with change: maintains performance during period(s) of change and understands changes in tasks and/or environment as well as the basis for change
• Possesses ability to professionally communicate (in all forms) with payer resources such as websites, e-mail, telephone, customer service departments, etc.
• Possesses a cooperative and positive attitude toward clients, management, and co-workers by responding politely and professionally and being a valued team player
• Ability to meet departmental standards for quality and productivity.

Requirements:

• Must have a minimum of 3 years' experience in a Customer Service call center environment with a focus on healthcare billing/collections or a collection agency environment or 3 years' experience working in a client service or marketing capacity, preferably in a healthcare or collection agency environment. General hospital A/R account knowledge is required.
• PC skills in a Windows environment are required.
• Solid knowledge and utilization of desktop applications, to include Word and Excel, are essential. College education, previous insurance company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience.