Title: Patient Accounts Representative II - Appeals/Denials
Summary
We are seeking a Patient Accounts Representative II to join our team. The candidate should be an experienced collector, and should have an understanding of A/R follow-up. The candidate should also have knowledge of how to appeal a denied claim and check the status of a claim by accessing payer websites or placing a telephone call to the payer.
Job Duties
- Assists the A/R follow up team with payment reimbursement.
- Calls insurance companies or accesses payer websites for claim status, appeal status on denied claims, and payment reimbursement.
- Expedites and maximizes payment of insurance medical claims by contacting 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 & resolve denials, unpaid accounts, partially paid accounts, and requests for information, including appeals.
- Reviews invoices to verify payments and 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.
- 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
- 3 years of A/R follow-up 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.
10526
CA