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Title:  Patient Accounts Representative II - Appeals and Denials

Division:  Patient Business Services
Schedule:  Monday - Friday, 8:00 a.m- 5:00 p.m.
Work Location:  Houston, TX
Salary Range:  $31,581 - $42,714
FLSA Status:  Nonexempt
Requisition ID:  9496

Summary

The Patient Account Representative II requires an experienced collector that understands AR follow up.  Should have knowledge of how to appeal a denied claim and check status of a claim by payer website or placing a telephone call to the payer.

Job Duties

  • Assists the AR follow up team with payment reimbursement.
  • Calls insurance companies or accesses payer website for claim status.
  • Appeals status on denied claims and payment reimbursement.
  • Expedites and maximizes payment of insurance medical claims by contacting the patients or insurance companies concerning unpaid accounts receivables via telephone or online systems.
  • Follows up on outstanding accounts and makes proper notations (updating insurance information, using correct activity codes) in the Epic system. 
  • Investigates & resolves denials, unpaid accounts, partially paid accounts and requests for information, including appeals. 
  • Reviews invoices to verify payments accurate contractual adjustments. 
  • Updates patient information and files medical claims with correct information, via electronic or paper submission.
  • Assists with inquiries from outside parties regarding account status. 
  • Resolves all denials, and requests for information, including appeals.
  • Provides guidance and technical work direction to less experienced Patient Account Representatives.


 

Minimum Qualifications

  • High school diploma or GED.
  • Two years of relevant experience.

Preferred Qualifications

  • Experience in AR follow up and speaking with the insurance company reps for claim status.  
  • Experience with accessing the payer website for claim information.  
  • Experience in submitting an appeal for reimbursement.
  • Three years of experience.

 

 

Baylor College of Medicine requires employees to be fully vaccinated -subject to approved exemptions-against vaccine-preventable diseases including, but not limited to, COVID-19 and influenza.

 

Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.

 9496

CA