Job Ref: 16543
Talent Area: Administrative/Clerical
Houston Methodist Specialty Physician Group
Houston, TX 77030
Area/Department: EPIC-A/R Specialty
Employment Type: Regular
Job Type: Full-Time
Organization: Houston Methodist
Work Shift: DAY
Work Week: M - F
Houston Methodist Specialty Physician Group - As one of the nation’s leading hospitals and academic medical centers Houston Methodist has brought together some of the nation’s leading experts in multiple specialties to serve our patients. As part of Houston Methodist Specialty Physician Group (HMSPG), these specialists not only provide excellent clinical care, but are on the forefront of research, developing leading-edge technologies and treatments, and teaching the medical pioneers of tomorrow. This combination of clinical service, research and academics ensures patients have access to the latest in treatments and technologies while providing the best in comprehensive patient care. Established as a non-profit corporation and certified by the Texas State Board of Medical Examiners, HMSPG enables physicians to maintain autonomy with respect to their clinical practice while growing their practice within an academic environment.
The Accounts Receivable (AR) Representative I is responsible for processing all billing related functions within the PO Centralized Business Office (CBO). This includes data entry of charges into Epic®, when necessary; and processing actions to release charges/claims from Epic®. The AR Representative I demonstrates general knowledge of billing practices and maintains departmental standards relating to billing functions. This role is also responsible for providing support to other departments within the PO CBO related to billing functions.
System and department specific ICARE values
INTEGRITY: We are honest and ethical in all we say and do.
COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
ACCOUNTABILITY: We hold ourselves accountable for all our actions.
RESPECT: We treat every individual as a person of worth, dignity, and value.
EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.
DUTIES AND RESPONSIBILITIES
¿ Collaborates with the revenue cycle team to follow up on missing data that may delay claims submission
¿ Assists with knowledge sharing, payor and department training, and provide support to other team members as advised by the Manager and/or Supervisor
¿ Resolves edits related to billing within established Epic® charge review and claim edit work queues to ensure claims are billed appropriately and timely
¿ Enters professional charges into Epic® and any associated actions to perform charge capture. Ensures completeness and accuracy of billing data (ICD-9, CPT, modifiers, etc.), when necessary.
¿ Expedites payment of insurance medical claims by promptly billing the claims
¿ Meets productivity and quality standards
¿ Documents clear, concise and complete notes in system for each account worked, when necessary
¿ Assures claims are corrected and worked at a high level of quality by visually proofreading and monitoring work output
¿ Demonstrates the components of The Houston Methodist Experience Service Standards and translates them into specific expectations of staff to anticipate and meet customer service needs
¿ Demonstrates and supports the Houston Methodist vision, mission and I CARE values statement
¿ Maintains strict confidentiality of patients, employees and hospital information at all times
¿ Ensures protection of private health and personal information. Adheres to all HIPAA and PCI compliance regulations.
¿ Identifies claims processing issues and general billing trends and notify Supervisor and/or Manager to avoid further delay in claims processing
¿ Remains current on billing procedures of various payors and specialty practices as directed by the Supervisor and/or Manager
¿ Accountable for ongoing professional growth and development and participation in team meetings
High School Diploma or G.E.D., Associates degree years college preferred
1 year of physician billing experience preferred in a multi-specialty physician practice
3 years of clerical experience preferred
CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
¿ Knowledge of Epic® or professional and hospital system billing software related to registration, charge entry/billing and payment posting preferred
¿ Strong communication (verbal and written), organizational, problem solving and team player skills
¿ Ability to multi-task in a fast paced environment, prioritize projects and work independently with attention to detail
¿ Demonstrate a high level of professionalism, customer service and interpersonal skills and operate under strict confidentiality due to the significant amount of PHI
¿ Strong phone and computer skills
¿ Knowledge of insurance requirements for physician visits and procedures
¿ Ability to think critically and identify the global impact across the revenue cycle with a solution oriented approach
Activity Checklist attached (see below)
Houston Methodist is an Equal Opportunity Employer.
Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law.
VEVRAA Federal Contractor – priority referral Protected Veterans requested.