Insurance Claims & Denials Specialist

CORP - HM Corporate Division - The Methodist Hospital; Texas; Presencial; USD 42 000 - 64 000; Tempo integral

Resumo da oferta

Houston Methodist in Houston, TX is seeking an Account Representative to resolve third-party insurance claims for professional services and perform collections on denials and outstanding balances.

The role requires strong English communication, CPT-4/ICD-9/10/HCPCS coding knowledge, and payer policy familiarity, with an emphasis on analyzing denial trends to prevent delays in payments.

Qualificações

• Three years of physician billing experience.
• Strong English reading/writing skills for patient safety communications.
• Proficiency in CPT-4, ICD-9/10, and HCPCS coding.
• Knowledge of third party payor reimbursement policies and denial trends.
• Understanding of payer environments (managed care, IPAs, TPAs).
• Experience with revenue cycle fundamentals and appeals process.

Responsabilidades

• Collaborates with management to reduce aging of accounts by communicating with payors and patients.
• Identifies denial trends and notifies supervisor to prevent future denials and delays in payments.
• Assists with knowledge sharing, cross training, and support to team members as advised.

Conhecimentos

Communication skills

Multi-tasking

Computer skills

English proficiency

Coding knowledge

Payor knowledge

Negotiation skills

Attention to detail

Formação académica

High School diploma or equivalent education

Descrição da oferta de emprego

Houston Methodist in Houston, TX is seeking an Account Representative to resolve third-party insurance claims for professional services and perform collections on denials and outstanding balances.

The role requires strong English communication, CPT-4/ICD-9/10/HCPCS coding knowledge, and payer policy familiarity, with an emphasis on analyzing denial trends to prevent delays in payments.