Catholic Health Initiatives Billing Rep/Collections in PASADENA, Texas
Patients Medical Center (PMC) provides inpatient and outpatient medical and surgical services to residents of Pasadena, Deer Park, La Porte, Baytown, and Clear Lake. The facility includes 53 medical/surgical beds, eight ICU beds and three endoscopy rooms, and offers a range of primary and specialized services—wound care, general surgery, gastroenterology, occupational health, heart and vascular, women’s services, diagnostic imaging, outpatient rehab services, and sleep disorders.
Responsible for identifying and collecting patient financial obligation for the duration of stay as well as verifying the eligibility/benefits information for the patient’s visit. will also determine eligibility for the hospital’s various financial assistance programs.
Education and Licensure
- High School Diploma/GED
- One (1) years of experience
Preferred: Insurance Collections Experience - Managed Care, Non -Government payers.
Minimum Knowledge, Skills, and Abilities
Excellent customer service skills
Excellent Written/verbal communication skills
Basic knowledge of medical terminology
Knowledge of HMO’s , PPO’s, Commercial/Governmental payers and System/Entity specific hospital contracts with Third Party payers
Basic knowledge of HIPPA and EMTALA
Preferred - Additional skill set:
Responsible for all aspects of follow up and collections, including making telephone calls, accessing payer websites.
Identify issues or trending and provide suggestions for resolution.
Accurately and thoroughly documents the pertinent collection activity performed.
Review the account information and necessary system applications to determine the next appropriate work activity.
Verify claims adjudication utilizing appropriate resources and applications.
Initiate telephone or letter contact to patients to obtain additional information as needed.
Edit claims to meet and satisfy billing compliance guidelines for electronic submission.
Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
Participate and attend meetings, training seminars and in-services to develop job knowledge.
Communicate issues to management, including payer, system or escalated account issues.
Performs collection Functions and financial assistance for payment methods
Conducts interviews with patients and/or family members
Collect and/or negotiate point of service payments or link to financial assistance programs
Must be capable of articulating information in a courteous, clear and informative manner to patients, guarantors, family members, clinical staff, other hospital personnel, vendors, physicians, and their office staff
Convey estimates of the patient responsibility portion of the billed cost of service to patients under deductible, coinsurance, and standard co-pay benefit designs based on established charge estimates for common procedures
Counsels patients regarding their third-party coverage, financial responsibility, and billing procedures
Review patient account summaries of unbilled charges, billing, payments, and collection activities
Obtain all forms required for patients potentially qualifying for financial assistance
Review and monitor accounts for inpatients and initiate proper action
Ensures payers are listed Accurately, pertaining to primary, secondary, and/or tertiary coverage and billing when a patient has multiple third party/governmental payers listed on an account.
Process patient accounts and deploy established policies to resolve insurance issues with patient accounts with/without supervision i.e. conference calls with employer, payer and physician office staff
Initiate pre-cert for in-house patients when required, obtaining pre-certification reference number, approved length of stay, and utilization review company contact person and telephone number
Primary Location TEXAS-PASADENA
Daily Schedule FTE
Scheduled Hours per 2-week Pay Period 80
Weekends Required Occasional
Req ID: 1800001010
We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.