Account Representative

 
Position: Account Representative

Job ID: 148085

Department: PFS AR MANAGEMENT -PB COMMERC

Talent Area: Administrative Support

Full/Part Time: Full-Time

Regular/Temporary: Regular

About Texas Children's Hospital

Texas Children’s Pediatrics is the nation’s largest primary pediatric care network with more than 200 physicians dedicated to the health care needs of infants to teenagers in over 50 locations throughout the greater Houston area. As part of our goal to build a community of healthy children, Texas Children's Pediatrics Community Cares Program provides trusted, high-quality pediatric medical services for children who otherwise would seek care from emergency centers or possibly go without care or treatment due to low family incomes and/or lack of health insurance. To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org

Summary:

We are searching for an Account Representative – someone who works well in a fast-paced setting. In this position, you’ll provide collections follow-up on all assigned accounts receivable to ensure continuity of cash flow and the collection of every collectible dollar, efficiently resolving accounts. It will be your responsibility to ensure that Texas Children’s Hospital is reimbursed according to all contractual commitments as well as government regulations. This position will also assist with the application process of charity or payment plans for the guarantors and families who may need assistance. You’ll be responsible for appealing all underpayment and technical denials within each payor’s contractual guidelines as well as government timelines. You’ll work closely with admission, billing, medical records, care management, and contracting to retrieve information supporting appeals and communicating denial trends.



Responsibilities :

  • Initiate timely contact with guarantors and third-party payors to collect outstanding receivables as well as underpayment or denied payment
  • Maintain accounts receivable by following established departmental policy, procedure, workflow and departmental goals

Report inaccurate reimbursement balances and make prudent decisions on appropriate actions needed to resolve the balance



Qualifications:

  • General knowledge of government, commercial and managed care reimbursement methodologies and understanding of all federal, state, and local legal aspects of collection regulations
  • The knowledge of how managed care plans work and the requirement for insurance coverage and benefits
  • Strong math aptitude to be able to verify appropriate reimbursement based upon the contract terms, benefits and/or government regulations
  • High School Diploma required
  • 2 years of revenue cycle experience required


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