Commercial Collector
- Job Ref:
- JR-7700
- Job Shift:
- Day
- Job Type:
- Full Time
Non-exempt
QUALIFICATIONS
EDUCATION
- High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
EXPERIENCE
- Five years of experience in commercial insurance follow-up, preferably in hospital accounts receivable
SKILLS AND ABILITIES
- Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
- Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
- Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
- Extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers Comp, Commercial plans, etc.; knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation
- Extensive knowledge of billing, collections, reimbursement, contractual agreements and the appeals process
- Understanding of revenue cycle fundamentals
- Ability to follow-through and handle multiple tasks simultaneously
- Excellent communication and negotiation skills, as well as an ability to work independently and interdependently with other business office staff
- Good judgment in handling of accounts and ability to apply a professional approach in dealing with patients and insurance companies
- Sharp analytical abilities in order to resolve patient accounts in a timely and correct manner
- Proficient computer skills and ability to learn and navigate multiple software programs
- Ability to remain calm in stressful situations with patience and understanding
- Ability to approach problems with an open mind and contribute to solutions
- Strong training, leadership and mentoring skills
ESSENTIAL FUNCTIONS
PEOPLE ESSENTIAL FUNCTIONS
- Promotes a positive work environment and contributes to a dynamic team focused work unit that actively helps one another to achieve optimal department and organizational results
- Strikes a balance between maintaining trustful relationships and ensuring timely payments. Exhibits professionalism and trustworthiness
- Serves as a resource and trainer for less experienced and new staff; orients, guides and mentors team members to help build confidence and competency in skills, knowledge and abilities
SERVICE ESSENTIAL FUNCTIONS
- Reviews incoming correspondence and takes appropriate action. Responds promptly to payor’s request for additional information/documentation. Confers with Billers, as necessary, to obtain additional information/clarification
- Takes a more participatory role in meetings and negotiations with Insurance Provider Relation and collaborations with third party vendors and projects
- Informs manager of payer trends or any problems or changes in payor requirements, including any barriers or obstacles
QUALITY/SAFETY ESSENTIAL FUNCTIONS
- Obtains corrected information and requests rebills as needed
- Provides clear and concise documentation of every action taken on an account in the system collection notes. Provides balance breakdown to document the status of next responsible party (i.e., primary, secondary payor, patient balance, or credit balance)
- Effectively manages inventory in accordance with departmental standards. Identifies accounts for advanced due diligence steps or legal placement
- Meets or exceeds stated Performance Indicator Expectations (e.g., productivity, account reviews, agings) as demonstrated on weekly Key Performance Indicator
FINANCE ESSENTIAL FUNCTIONS
- Follows up on assigned delinquent insurance claims. Ensures maximization of collection dollars from insurance companies in accordance with the respective contract and/or Houston Methodist financial arrangement. Works assigned higher dollar accounts, major/ complicated payors, or large inventory work queues as directed
- Analyzes accounts for errors, adjustments and credits, issuing corrected entries when necessary. Updates account information accordingly. Follows levels of authority for posting adjustments, refunds, and contractual allowances
- Uses resources effectively and efficiently. Organizes time effectively, minimizing incidental overtime, and sets priorities. Utilizes time between heavy workloads efficiently and helps other team members
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
- Stays current on collection procedures of various payors and industry trends. Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development
- Generates and communicates new ideas and suggestions that will improve quality or service. Demonstrates adaptability and flexibility in the face of changing demands
SUPPLEMENTAL REQUIREMENTS
- WORK ATTIRE
- Uniform: No
- Scrubs: No
- Business professional: Yes
- Other (department approved): Yes
- On Call* No
- May require travel within the Houston Metropolitan area No
- May require travel outside Houston Metropolitan area No
ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.
TRAVEL**
**Travel specifications may vary by department**
EDUCATION
- High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
EXPERIENCE
- Five years of experience in commercial insurance follow-up, preferably in hospital accounts receivable
Company Profile:
Houston Methodist is one of the nation’s leading health systems and academic medical centers. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area. Houston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. Come lead with us!
Houston Methodist is an Equal Opportunity Employer.
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