Patient Account Representative II - Rev Cycle

UTHealth Houston; Houston (TX); Remote; USD 40,000 - 56,000; Full time

Job summary

UTHealth Houston in Texas is seeking a Patient Account Representative II to support Revenue Cycle, with a focus on insurance follow-up and denials resolution. The role covers back-end functions from discharge to final account resolution to ensure timely reimbursement.

Requirements include a high school diploma, three years hospital collections experience, and proficiency in MS Office and Excel. This is a remote position with occasional onsite meetings in Texas.

Qualifications

• Basic knowledge of patient billing or collection/reimbursement procedures in a healthcare setting.
• Three years hospital/medical collections experience with understanding of third party reimbursement procedures and relevant regulations.
• Proficient in MS Office with emphasis in Excel; 10-key and math skills.

Responsibilities

• Manage multiple work queues for follow-up and denials by engaging payer websites and initiating calls to ensure prompt payment of medical claims.
• Review incoming correspondence and take appropriate action; respond promptly to inquiries.
• Identify denial trends and notify Supervisor/Manager to prevent future denials and delays in payments.
• Pursue appeals and take steps to bring accounts to resolution.
• Analyze accounts for errors, adjustments and credits; issue corrected entries and update account information.

Skills

MS Office

Excel

10-key

Math

Patient billing

Education

High School Diploma or equivalent

Tools

EPIC Professional Billing

Job description

UTHealth Houston is hiring the Patient Account Representative II position within Revenue Cycle to join their team of professionals! This positions is for the back-end functions of the revenue cycle process, covering the full spectrum of patient accounting services. It places a strong emphasis on insurance follow-up and denials resolution as core areas of specialization.

• Manages account resolution related to insurance follow-up and denials management
• Overseas back-end revenue cycle functions from discharge through final account resolution
• Coordinates with payers to resolve outstanding claims and ensure timely reimbursement
• Specializes in identifying, tracking, and resolving claim denials to reduce delays and prevent revenue loss
• Payer Portal Management: Performing payer reconsiderations and appeals tasks directly via portals.
• Plan Proficiency: Deeply understanding payer plan types, processes, and requirements.
• Trend Analysis: Investigating and identifying broader payer trends.
• Billing & Coding: Applying a basic understanding of professional billing and coding practices.
• System Knowledge: Utilizing knowledge of EPIC Professional Billing.

Location: Remote (2- 4 weeks onsite for training, 1851 Crosspoint Ave, 77054). Must be able to attend any required onsite meetings.

This is a Remote position, but you must reside in Texas.

• We DO NOT provide lodging or mileage reimbursement for training

What we do here changes the world.

UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.

Once you join us you won't want to leave.

It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus:

• 100% paid medical premiums for our full-time employees
• Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year)
• The longer you stay, the more vacation you’ll accrue!
• Longevity Pay (Monthly payments after two years of service)
• Build your future with our awesome retirement/pension plan!

We take care of our employees!

As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as...

• Free financial and legal counseling
• Free mental health counseling services
• Gym membership discounts and access to wellness programs
• Other employee discounts including entertainment, car rentals, cell phones, etc.
• Resources for child and elder care
• Plus many more!

Position Summary:

The patient account representative is responsible for the timely collection of third party and private pay receivables within regulatory guidelines.

Position Key Accountabilities:

• Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls in order to ensure prompt payment of medical claims.
• Reviews incoming correspondence and takes appropriate action. Responds promptly to inquiries.
• Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments.
• Pursues appeals and takes the necessary steps to bring accounts to resolution.
• Analyzes accounts for errors, adjustments and credits, issuing corrected entries when necessary. Updates account information accordingly.
• Communication documentation demonstrates clear action taken on each account as well as what further action is needed to capture payment. Work output is documented clearly, so that various departments involved in resolution can review the account.
• Ability to meet departmental standard for quality and productivity.
• Other duties as assigned.

Certification/Skills:

Basic knowledge of business office, patient billing, or collection/ reimbursement procedures in a healthcare setting; proficient in MS Office with emphasis in Excel, 10-key and math.

Minimum Education:

High School Diploma or equivalent

Minimum Experience:

Three years hospital/ medical collections experience with understanding of third party reimbursement procedures, as well as state and federal regulations governing healthcare.

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:

This position is a security-sensitive position pursuant to Texas Education Code

• 51.215 and Texas Government Code
• 411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code
• 117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R.
• 791.4. Residency Requirement:

Employees must permanently reside and work in the State of Texas.