Physician Medical Billing and Collections Specialist

Nexus Health Systems; Houston (TX); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a Physician Medical Billing and Collections Specialist to join their dynamic team. This entry-level role involves managing patient accounts, ensuring accurate billing, and facilitating timely collections. You will be responsible for verifying claims, following up on unpaid accounts, and preparing reports for executive review. If you are detail-oriented and have a passion for healthcare, this is a fantastic opportunity to begin your career in a supportive environment that values your contributions and offers growth potential.

Qualifications

• 1 year experience in hospital business office or medical billing/collections.
• High school diploma required; 1-2 years college preferred.

Responsibilities

• Verify admission documentation and claim accuracy per payer guidelines.
• Follow up on unpaid claims past contractual deadlines for 100% collection.
• Document payments and adjustments daily.

Skills

Medical Billing

Collections

Communication Skills

Attention to Detail

Education

High School Diploma

1-2 Years College

Job description

Physician Medical Billing and Collections Specialist

Join to apply for the Physician Medical Billing and Collections Specialist role at Nexus Health Systems.

Position Summary:

The System Coordinator, Patient Accounts II, serves as the secondary gatekeeper for the Nexus Health Systems Business Office. This role handles incoming calls, correspondence, and patient account documentation for accounts aged 61+. It verifies that patient financial folders contain complete and accurate billed claims, supporting timely and accurate collections as per contracts. The role also involves creating Federal and State-mandated reports.

Key Responsibilities:

• Respond to routine telephone inquiries or route calls appropriately.
• Verify admission documentation and claim accuracy per payer guidelines.
• Communicate with internal and external parties to gather additional patient information for collections.
• Ensure claims are billed and received; maintain patient financial folders and correspondence.
• Request rebilling for denied or missing claims, ensuring timely reimbursement.
• Follow up on unpaid claims past contractual deadlines, aiming for 100% collection of charges.
• Confirm electronic claims are received without rejection; promptly address rejected claims.
• Document payments, adjustments, and patient responsibilities daily.
• Submit adjustments within 24 hours of receipt of payments or EOBs.
• Document collection efforts on accounts aged 60+ days; follow up every 7-14 days.
• Prepare monthly summaries for accounts aged 90+ for executive review.
• Respond to correspondence within 24 hours.
• Coordinate with facility personnel for documentation needed for appeals or payment rectification.
• Handle denial correspondence and file all related documents appropriately.
• Identify and process credit balances for federal and state agencies monthly.
• Work assigned accounts twice a month, with follow-up as needed.
• Manage paid accounts and ensure file completeness for audits.
• Identify process or reimbursement issues and assist other team members as needed.
• Perform other duties as assigned.

Qualifications:

• High school diploma required; 1-2 years college preferred.
• Minimum of 1 year experience in hospital business office or medical billing/collections.
• No licensure or certification required.

Additional Details:

• Seniority Level: Entry level
• Employment Type: Full-time
• Job Function: Healthcare Provider
• Industry: Hospitals and Healthcare