Title:  Patient Accounts Representative II - Appeals/Denials

Division:  Patient Business Services
Schedule:  Monday - Friday, 8:00 am - 5:00 pm
Work Location:  Houston, TX
Salary Range:  $31,581 - $42,714
FLSA Status:  Nonexempt
Requisition ID:  10526

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