Collections Representative

Accounts Recovery Specialist

Premier Medical Resources is looking for an Accounts Recovery Specialist to join our team. Hybrid opportunity after 30-90 day in-person training (3 days from home 2 days in office). The Accounts Recovery Specialist is responsible for providing medical collection services for medical professional clinics. Performing collection activities related to follow-up account resolution and communication to patients, offsite associates, reimbursement vendors, and other external entities. This position utilizes a strong background in medical collection to successfully resolve accounts for collection. Associates in the collection units are expected to maintain knowledge of the overall collection work processes for both active AR and BD inventory. In addition, maintaining patient and physician satisfaction while adhering to all physician state and federal guidelines.

Essential Functions:

• Ensures daily productivity standards are met
• Communicates and/or negotiates problematic accounts
• Contacts providers for verification of patient records
• Uploads and maintains data using 3rd party portal accounts such as Availity
• Fulfills internal and external requests for outcome data including developing special reports
• Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work standards
• Provides effective collection services ensuring the successful recovery of accounts in accordance with state guidelines as well as Premier Medical Resources and Minivasive Pain and Orthopedics business objectives
• Documents and updates patient account information in Recovery Cycle Management collection software system timely and accurately to include appropriate account status
• Ensures all documentation is accurate and compliant with federal laws in terms of composition
• Handles inbound and outbound patient and/or carrier calls promptly and professionally providing assistance and resolution to account inquiries, issues, and requests
• Performs research and analysis of account issues and strives to resolve problems timely and accurately
• Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignity of patients and/or their families
• Reviews payment denials, underpayments, and payment take backs for appropriateness and guides resolution by resubmission to the insurance carrier, patient billing, or appropriate adjustment
• Protects patient and family privacy rights and maintains confidentiality of patient records in accordance with policy, procedure, and HIPAA requirements
• Other duties as assigned

Knowledge, Skills, and Abilities:

• General knowledge of revenue cycle account recovery accounts
• Knowledge of health insurance claims, billing, collection, and resolution
• Solid knowledge and utilization of PC and desktop applications to include Word and Excel
• Knowledge of in and out of network insurances, Workers Compensation insurance verification, and patient responsibility
• Knowledge of interpreting EOBs, posting payments, and adjusting accounts appropriately
• Knowledge of ICD-10 and CPT codes and procedures
• Knowledge of medical coding guidelines and regulations
• Working knowledge of medical jargon and anatomy
• Demonstrate task-oriented and have organizational skills
• Strong attention to detail being careful about detail and thorough in completing work tasks
• Ability to work independently by guiding oneself with little or no supervision
• Ability to communicate professionally with outside parties
• Ability to adapt with flexibility

Education and Experience:

• High School Diploma or GED
• Two (2) years of experience in medical account recovery

Premier Medical Resources is a healthcare management company headquartered in Northwest Houston, Texas. At Premier Medical Resources, our goal is to leverage and combine the expertise and skillset of our employees to drive quality in all we do. Our goal is to create career pathways for our employees just starting their professional career and to those who seek to bring their expertise and leadership as we strive to combine best practices and industry excellence. Come join our team at Premier Medical Resources where passion and career meet. Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data. Employment with Premier Medical Resources is contingent on the successful completion of a pre-employment drug screen and background check.