Accounts Recovery Specialist (Facility)

RiseMe; Houston (TX); Hybrid; USD 38,000 - 62,000; Full time

Benefits offered by this job

3 Medical Plans

2 Dental Plans

2 Vision Plans

Employee Assistant Program

Disability Insurance

AD&D Plan

401(k) with 2-year vesting

PTO + Holidays

Job summary

Premier Medical Resources, based in Northwest Houston, Texas, is seeking an Accounts Recovery Specialist to perform medical collection duties for hospital systems and associated surgery centers. The role involves follow-up, account resolution, and communication with patients, offsite associates and vendors, using recovery software and portals.

The ideal candidate will have two years of medical account recovery experience, strong knowledge of EOBs, ICD-10, CPT codes, and a solid command of Excel.

Qualifications

• Understanding of Revenue Cycle account recovery processes.
• Knowledge of health insurance claims, billing, and resolution.
• Familiarity with HIPAA requirements and patient privacy.

Responsibilities

• Meet daily productivity standards.
• Communicate and negotiate with problematic accounts.
• Verify patient records with providers.
• Upload and maintain data in third-party portals like Availity.
• Generate and provide reports on outcomes and data.

Skills

Revenue Cycle

Account Recovery

HIPAA compliance

EOB interpretation

ICD-10 & CPT

MS Excel

Education

High School Diploma or GED

2 years medical account recovery experience

Tools

Availity portal

Recovery Cycle Management system

Job description

Revenue Cycle Managementis looking for an full-timeAccounts Recovery Specialistto join our team! *Remote opportunity after 30-90 days of on-site training*

SUMMARY:

The Accounts Recovery Specialist is responsible for providing medical collection services for Hospital systems and all associated Surgery Centers. Performing collection activities related to follow-up, account resolution and communication to patients, offsite associates, reimbursement vendors, and other external entities. This position utilizes a strong background in medical collection to successfully resolve accounts for collection. Associates in the collection units are expected to maintain knowledge of the overall collection work processes for both active AR and BD inventory. In addition, maintaining Patient and Physician satisfaction while adhering to all physician, state and federal guidelines.

• Ensures daily productivity standards are met
• Communicates and/or negotiates problematic accounts
• Contacts providers for verification of patient records
• Uploads and maintains data using 3rd party portal accounts such Availity
• Fulfills internal and external requests for outcome data, including developing special reports
• Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work
• standards
• Provides effective collection services, ensuring the successful recovery of accounts in accordance with state
• guidelines as well as Premier Medical Resources and Townsen Memorial Hospital business objectives
• Documents and updates patient account information in Recovery Cycle Management collection software system
• timely and accurately to include appropriate account status
• Ensures all documentation is accurate and compliant with federal laws in terms of composition
• Handles inbound and outbound patient and/or carrier calls promptly and professionally, providing assistance andresolution to account inquiries, issues, and requests
• Performs research and analysis of account issues and strives to resolve problems timely and accurately
• Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignityof patients and/or their families
• Reviews payment denials, underpayments, and payment take backs for appropriateness and guides resolution byresubmission to the insurance carrier, patient billing, or appropriate adjustment
• Protects patient and family privacy rights and maintains confidentiality of patient records in accordance with policy, procedure and HIPPA requirements
• Other duties as assigned

KNOWLEDGE, SKILLS, AND ABILITIES:

• General knowledge of Revenue Cycle account recovery accounts.
• Knowledge of health insurance claims, billing, collection and resolution.
• Solid knowledge and utilization of PC and desktop applications to include Word and Excel.
• Knowledge of in and out of network insurances, Workers Compensation, insurance verification, and patientresponsibility.
• Knowledge of interpreting EOBs, posting payments, and adjusting accounts appropriately.
• Knowledge of ICD-10 and CPT codes and procedures.
• Knowledge of medical coding guidelines and regulations.
• Working knowledge of medical jargon and anatomy.
• Demonstrate task-oriented and have organizational skills.
• Strong attention to detail, being careful about detail and thorough in completing work tasks.
• Ability to work independently by guiding oneself with little or no supervision.
• Ability to communicate professionally with outside parties.
• Ability to adapt with flexibility.

EDUCATION AND EXPERIENCE:

• High School Diploma or GED
• Two (2) years of experience in medical account recovery

BENEFITS:

• 3 Medical Plans
• 2 Dental Plans
• 2 Vision Plans
• Employee Assistant Program
• Short- and Long-Term Disability Insurance
• Accidental Death & Dismemberment Plan
• 401(k) with a 2-year vesting
• PTO + Holidays

Premier Medical Resourcesis a healthcare management company headquartered in Northwest Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career, and to those who seek to bring their expertise and leadership as we strive to combine best practices and industry excellence. Come join our team at Premier Medical Resources where passion and career meet.

Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Employment for this position is contingent upon the successful completion of a background check and drug screening.