Account Representative

Prime Healthcare•Harlingen, TX

12d•Onsite

About The Position

The Account Representative works at the Harlingen Central Billing Office in Harlingen, Texas, on day shifts consisting of 8-hour shifts. The role handles hospital account and payment activities, including posting and reconciling incoming payments, applying contractual adjustments, and maintaining accurate patient account balances. It also involves reviewing insurance payments and managed care contracts for correct reimbursement and regulatory compliance, investigating underpayments and denials, managing billing and mail, and communicating professionally with patients, families, and internal stakeholders.

Requirements

Ability to multitask and prioritize needs to meet required timelines.
Effective written and verbal communication skills.
High school graduate or GED equivalent required (effective 4/1/14 for all new hires).
Knowledge of basic medical coding and third-party operating procedures and practices.
Medical and insurance terminology is essential.

Nice To Haves

Analytical, mathematical, and problem-solving skills preferred.
Customer service experience preferred.
Experience in accounts payable, accounts receivable, or cashier work preferred.
Familiarity with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology preferred.
Knowledge of multiple insurance billing requirements and 6 months to 1 year of billing experience preferred.

Responsibilities

Accurately post and reconcile daily incoming payments, apply contractual adjustments, and maintain correct patient account balances within hospital systems.
Analyze insurance payments and managed care contracts to ensure accurate reimbursement and compliance with state and federal regulations, including Worker’s Compensation fee schedules.
Identify, investigate, and escalate underpayments or denials while collaborating with payers and internal departments to optimize revenue collection.
Distribute billing appropriately, manage hospital-related incoming and outgoing mail, and promptly correct mailing discrepancies.
Provide professional, tactful communication when assisting patients, families, and internal stakeholders regarding account inquiries and payment matters.