Description Account Representative

　　Immediate opening for 2 account representatives

　　The duties of the Account Representative include:

　　• Initiates calls or online web contact to payors or guarantors to verify receipt of claims/statements and collect on outstanding accounts receivables.

　　• Documents follow-up activities, conversations with payors/guarantors, information obtained via the web contact, and any correspondence in the account notes.

　　• Ensures payments received by third party payors are correct and the correct contractual discounts/allowances have been applied according to the contract matrix or government reimbursement rates.

　　Ensures that all accounts associated with that guarantor and payor relationship are resolved.

　　• Analyzes and assesses accounts for outstanding balances and makes prudent decisions on appropriate actions needed to resolve the balance

　　• Identifies and reports inaccurate reimbursement and contractual trends to Sr. Reps, Team Lead, or Manager.

　　• Refers problem accounts to Sr. Rep, Team Lead or Manager prior to accounts becoming 60 days old.

　　Documents the issues in detail and refers to Sr. Rep, Team Lead or Manager with a recommendation of action needed.

　　Provides continual follow-up.

　　• Assists with special projects to ensure that collection, work queue, and departmental goals are met.

　　To qualify for the Account Representative, you must have:

　　High School Diploma

　　Required 2 years revenue cycle experience with 2 years’ experience with the following:

　　Epic (PB), excel, outlook, Availity Physician Revenue Cycle and Insurance Collections experience with commercial payers – i.e BCBS, UHC, Cigna, and Aetna – is required. This includes appealing insurance claim denials, underpayments, and understanding root cause analysis of insurance related activities.

　　Medical Billing and general pediatric facilities experience

　　• Government, commercial and managed care reimbursement methodologies and understanding of all federal, state, and local legal aspects of collection regulations

　　.• The knowledge of how managed care plans work and the requirements for insurance coverage and benefits.

　　• Ability to communicate effectively both oral and written, good interpersonal skills; decision-making skills.

　　• Account Representatives must have a strong math aptitude in order to be able to verify the appropriate reimbursement based upon the contract terms, benefits and/or government regulations.

　　Experience in physician services denials management.

　　Specifically, researching payer trends, submitting appeals, tracking denials.

　　Experience with larger facilities and have a track record of being able to adapt to both quality and productivity standards.

　　Training is in-person at the Bellaire office; remaining is 90% remote.

　　Remote location requires quite location at home where PHI can be protected.

　　Applicants who do not have physician insurance collections experience and a minimum of 2 years of current job history will not be considered.

　　Experience with Excel and Epic is strongly preferred. Please note, while this is mostly a remote position, training will take place in office for up to 8 weeks Requirements Documentation, Microsoft Excel, Training, Procedures, Policy, Payment Processing, Quality, Microsoft Outlook, Insurance, Medical Coverage, Benefit Functions, Billing, Collection Processes, Claim Administration, Regulation, Facility, Financial Notes, Answer, Clinical Trial Operations, Receipt, Research Analysis, Web App, Interpersonal Skills, Lead Special Projects, Reimbursements

　　Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

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　　All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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