Patient Account Representative II

Texas Health Resources; Arlington (TX); Hybrid; USD 42,000 - 62,000; Full time

Job summary

Texas Health Resources is seeking a Patient Account Representative II in Arlington, TX. The role focuses on receivables management, researching account balances, and ensuring timely payment postings. You will contact payors and patients to secure accurate payments while applying HIPAA guidelines.

The position emphasizes accuracy, daily account work, and meeting productivity metrics. Experience in healthcare AR and familiarity with Epic are preferred.

Qualifications

• H.S. Diploma or Equivalent required.
• 2 Years Healthcare Revenue Cycle Accounts Receivable experience required.
• Hospital collections experience preferred.
• Managed Medicare experience preferred.
• Experience with Epic preferred.

Responsibilities

• Verify validity of account balances by researching, reviewing, and ensuring accuracy of payment and adjustment posting.
• Contact payors, patients, employers, and other responsible parties to obtain timely and accurate payments on assigned accounts receivable.
• Prepare appeal letters to dispute payor denials when appropriate.
• Process and/or request rebills and other system actions as needed.
• Enter all communications regarding patient accounts in the host system.
• Accounts should be worked daily with emphasis on quality and resolution.
• Worklists should be stratified to prioritize high-dollar and aged accounts to resolve inventory each week.

Skills

Communication skills

Problem solving

Customer service

Organizational skills

Attention to detail

Medical terminology knowledge

Epic experience

Education

High School Diploma or equivalent

Tools

Epic

Job description

Patient Account Representative II

Bring your passion to Texas Health so we are Better + Together

Work Location: Texas Health Corporate, 612 E. Lamar Blvd., Arlington, TX 76011

Work Hours: Remote: Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion)

Work Location: Texas Health Corporate, 612 E. Lamar Blvd., Arlington, TX 76011

Work Hours: Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion)

Department Highlights:

• Gain a sense of accomplishment by contributing to a teamwork environment.

• Receive excellent mentorship, comprehensive training, and dedicated leadership resources.

What You Will Do:

Receivables Management Collections

Verify validity of account balances by researching, reviewing, and ensuring accuracy of payment and adjustment posting.

Takes initiative to resolve accounts with and without supervision.

Contact payors, networks, patients, employers, and other responsible parties to acquire timely and accurate/expected payment on assigned Accounts Receivable inventory.

Take necessary steps needed to acquire and provide information needed for claims that have a zero payment.

Use payor-specific contract terms to resolve claims that are in process or have a payment variance.

Refer claims that have a clinical denial to the Denials team for review and follow-up.

Prepare appeal letters to dispute payor denials when appropriate

Process &/or request rebills and other system actions, as needed.

Understand and apply appropriate system discounts.

Enter all communications regarding patient accounts in the host system.

Accounts should be worked daily, with an emphasis on quality and resolution.

Worklists should be stratified to ensure high dollar and/or aged accounts are the top priority, with the overall goal of resolving assigned inventory each week.

Works towards department goals and visions as an individual and as a team player.

Meet, and maintain, quality and productivity performance metrics set forth by applicable leadership

Maintain proficiency in the host system

Receivables Management related to Financial Assistance PAR II?s

Review financial assistance application for completion prior to processing. Determines if application is complete. If incomplete, requests additional documents from consumer by phone, mail, or email following HIPAA privacy guidelines.

Documents, receipt of application in system and creates a Case in Financial Assistance Module. Uses appropriate activity code in Epic to ensure productivity is accurate.

Review incoming applications received by mail, email or MyChart, to determine if all the required information was submitted. If incomplete, requests additional documents from consumer by phone, mail, or email following federal HIPAA regulations

Processes accounts timely, according to age, and consumer request. Uses appropriate activity code in Epic to ensure productivity is accurate

Prepare and mails all approval/denial letters. Prepares documents for scanning, removes non-essential information from packets to protect consumers financial information.

50%

Focus on Service

Provide excellent service when dealing with payors, patients, employers, management, hospital staff and other parties within and outside of THR.

Communication should be clear, concise, and professional.

Requests should be addressed timely, with the goal of completion within 3 days to avoid delinquency.

Requests deemed as "escalated" should receive immediate attention.

20%

Payor Issues

Identify and resolve problems related to payor contracts and reimbursement in a timely manner.

Inform Business Operations Supervisor, Manager and/or Payor Champion of any potential trends that might delay accurate payment (via appropriate mechanism - spreadsheet, email, etc...)

Recommend accounts for placement with an outside collection/legal vendor when appropriate resolution is not obtained timely.

20%

Compliance

Compliance with THR policies and procedures.

Complies with all applicable regulations with the operating systems, entity, and system policies and procedures.

Complete assigned tasks in a timely and effective manner.

Maintain up-to-date knowledge of local, state, and federal guidelines for communication and collections.

10%

Education

H.S. Diploma or Equivalent Req

Experience

2 Years Healthcare Revenue Cycle Accounts Receivable Experience, healthcare or related organization. Req

Hospital collections experience Pref

Managed Medicare experience Pref

Skills

Computer skills required in advanced word processing, spreadsheets, and graphic skills.

Ability to organize and coordinate workflow as well as meeting deadlines.

Must possess excellent communication, problem solving documentation, training and customer service skills.

Must be familiar with organizing, managing workflow and ability to absorb and retain details.

General knowledge of medical and insurance terminology required.

Experience in Epic preferred

Supervision

Individual Contributor

ADA Requirements

Extreme Heat 1-33%

Extreme Cold 1-33%

Extreme Swings in Temperature 1-33%

Extreme Noise 1-33%

Working Outdoors 1-33%

Working Indoors 67% or more

Mechanical Hazards 34-66%

Electrical Hazards 1-33%

Explosive Hazards 1-33%

Fume/Odor Hazards 1-33%

Dust/Mites Hazards 1-33%

Chemical Hazards 1-33%

Toxic Waste Hazards 1-33%

Radiation Hazards 34-66%

Wet Hazards 1-33%

Heights 1-33%

Other Conditions 1-33%

Physical Demands

Sedentary

Texas Health requires a resume when an application is submitted.Employment opportunities are only reflective of wholly owned Texas Health Resources entities.

We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.