Job Details

Job Location: Remote Texas - Houston, TX 77025

Position Type: Full Time

Travel Percentage: None

Job Category: Health Care

LOCATION: 2855 Gramercy St. Houston, TX 77025

This is a Houston-based remote position with the option to work in office if preferred.

POSITION SUMMARY

Contributes to the organization by overseeing all functions of the business office operations by completing the follow-up and collection process from third party payers and self-pay accounts to enhance cash flow and obtain associated reimbursement based on established contracts. Responsible for working high-cost drug report for retina physicians.

ESSENTIAL DUTIES & RESPONSIBILITIES

• Performs follow up activities in a timely manner on all accounts to ensure prompt payment.
• Maintains daily queue on desktop.
• Identifies coding or billing problems from EOBs and work to correct the errors in a timely manner.
• Monitors insurance claims by running appropriate reports and contacting insurance companies and/or patients to resolve claims that are not paid in a timely manner.
• Prepares accounts for rebilling and for filing secondary insurance; sends to carrier with necessary documents, as needed.
• Completes filing and follow-up on insurance denials with coder and physicians to obtain reimbursement.
• Handles patient and insurance inquiries.
• Updates the patient account record to identify actions taken on the account.
• Updates systems and re-files claims, as required.
• Assigns Bad Debt accounts to Collection Agency as approved by Revenue Cycle Manager.
• Acts as a liaison in collection of third-party accounts, as assigned.
• Completes the reconciliation of accounts that are turned over to outside agencies.
• Notifies Revenue Cycle Manager of contractual issues that are contrary or inconsistent with contract language.
• Negotiates payment plans on self-pay accounts with the approval of Revenue Cycle Manager.
• Responsible for achieving and maintaining accounts receivable days at the established goal.
• Responsible for the reduction and maintenance of bad debt at the established goal.
• Performs weekly and monthly reviews and turnovers of aged accounts to an outside collection agency for 1st placements and bad debt, as determined through facility processes.
• Follows guidelines that include initial follow-up/first contact at 30 days for insurance claims and subsequent follow-up every 14 days.
• Answers telephones.
• Attends required meetings and participates in committees, as requested.
• Other duties as assigned based on business operational needs.

We Proudly Offer:

• Continuing Education including JCAHPO & ABOC
• Holidays & Paid Time Off
• Bereavement Leave
• Superior Benefits Package: Medical Dental 401(K) Free Life Insurance & LTD Eye Care Benefits & Optical Discounts

Equal Opportunity Employer M/F/H/V

Qualifications

COMPETENCIES

EDUCATION

High School Diploma or GED equivalent.

CERTIFICATIONS & LICENSES

Not applicable

EXPERIENCE

Minimum (1) years of collections experience in a medical office setting. (i.e. ambulatory surgery center, hospital, doctors office) Ophthalmology experience preferred.