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Position Details
Title: Medical Collector
Pay Rate: $20-23/hr
Hours: Monday - Friday, 8am-5pm CST
Location: 1213 Hermann Drive Suite 400 Houston Texas 77004
Why is this position open? Teammates have been promoted and natural attrition
Contract Duration: 800 hours / roughly 4-month-contract with Medix; ideally after the contract duration, Houston Methodist will convert you to being a full time permanent employee
OVERVIEW
Essential Functions
Collaborates with management to reduce aging of accounts by providing verbal and written communication
Identifies denial trends and notifies supervisor and/or manager to prevent future denials and further delay in payments
Collaborates with internal CBO departments and Account Managers to communicate and prevent denials
Provides suggestions for resolution
Assists with knowledge sharing, payor and department cross training, and provides support to other team members as advised by the manager and/or supervisor
Completes special projects to improve team performance, as assigned
Demonstrates expertise of all payers, including Medicare, Medicaid and commercial payors, and applicable department's revenue cycle operations
Ensures protection of private health and personal information
Adheres to all Health Insurance Portability and Accountability Act (HIPAA) and Payment Card Industry (PCI) compliance regulations
Reviews third party payor work queues to locate and resolve accounts
Resolves denials as they appear
Documents clear, concise and complete follow-up notes in system for each account worked
Assures accounts are completed and worked at a high level of quality by visually proofreading and monitoring work output
Identifies, analyzes and escalates trends impacting accounts receivable collections
Meets and/or exceeds established follow-up productivity goals
Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients including: making outbound calls to payers and accessing payor websites
Reviews and assesses entire account to determine necessary steps or activity to resolve outstanding denials
Performs appropriate billing functions, including claims resubmission to payors
Creates and submits appeals when necessary
Engages the coding follow-up team for any medical necessity or coding related appeals
Stays current on collection procedures of various payers and industry trends
Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development
*This job description is not intended to be all inclusive; the employee will also perform
other reasonably related business/job duties as assigned. Houston Methodist reserves
the right to revise job duties and responsibilities as the need arises.
EDUCATION REQUIREMENTS
High School diploma or equivalent education (examples include: GED, verification of
homeschool equivalency, partial or full completion of post-secondary education, etc.)
EXPERIENCE REQUIREMENTS & QUALIFICATIONS
3+ years of physician billing experience, preferably in a multi-specialty physician practice
High volume claims experience
Physician Billing experience is highly preferred but not required
Must be COVID vaccinated
EPIC experience is highly preferred but not required
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
In depth knowledge of Current Procedural Terminology, 4th Edition (CPT-4), International Classification of Diseases Ninth Revision (ICD-9), International Classification of Diseases Tenth Revision (ICD-10), and Healthcare Common procedure Coding System (HCPCS) coding
In depth knowledge of third party payor reimbursement policies and procedures
Understands payer environment such as managed care, independent physician associations (IPAs), and third-party administrators (TPAs)
Extensive knowledge of billing, collections, reimbursement, contractual agreements and the appeals process
Understanding of revenue cycle fundamentals
Ability to follow-through and handle multiple tasks simultaneously
Excellent communication and negotiation skills, as well as an ability to work independently and interdependently with other business office staff
Good judgment in handling of accounts and ability to apply a professional approach in dealing with patients and insurance companies
Sharp analytical abilities in order to resolve patient accounts in a timely and correct manner
Proficient computer skills and ability to learn and navigate multiple software programs
Ability to remain calm in stressful situations with patience and understanding
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