Patient Account Specialist Senior - TLRA Precollect

CHRISTUS Health•Tyler, TX

About The Position

Provides medical collection services for TLRA collection units, using a strong background in medical collections to resolve accounts placed with TLRA. The work includes follow-up and account-resolution activities and communication with patients, clients, reimbursement vendors, and other external entities while adhering to client, state, and federal guidelines. Patient and client satisfaction are essential. Associates in the collection units are expected to understand collection work processes for both active accounts receivable and bad-debt inventory. The role handles insurance, self-pay, and physician billing/collection accounts. It supports ethical recovery of outstanding balances, accurate account documentation, timely appeals, and resolution of payment and claim issues. It also requires effective teamwork, professional communication, and use of collection tools and software to meet productivity and quality standards.

Requirements

High school diploma or equivalent years of experience.
Three to five years of experience preferred.
Experience in a customer service call center environment focused on healthcare billing/collections or in a collection agency environment required.
General hospital accounts receivable knowledge required.
Solid knowledge and use of desktop applications, including Word and Excel.
Effective team membership and good communication skills.
Direct knowledge using Meditech and CollectLogix software.
College education, previous insurance company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience.

Nice To Haves

Three to five years of experience preferred.

Responsibilities

Meet the expectations of applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Provide effective collection services and recover accounts in accordance with client and state guidelines and TLRA business objectives.
Document and update patient account information and status in TLRA’s collection software system accurately and promptly.
Handle inbound patient and/or carrier calls promptly and professionally, resolving account inquiries, issues, and requests.
Use collection tools effectively to provide quality recovery services and meet or exceed established goals and work standards.
Research and analyze account issues and resolve problems accurately and promptly.
Meet daily productivity standards.
Promote positive patient relations through respectful communication with patients and/or their families.
Perform other special projects as assigned.
Maintain active knowledge of payor collection requirements and collect third-party payer balances in accordance with applicable state and federal laws.
Ensure thorough, ethical collection efforts, quality standards, and proper documentation of patient accounting records.
Contact other departments to obtain information needed for appeals, pending items, and other issues affecting or delaying claim processing.
Handle self-pay accounts in a customer-service-oriented manner while collecting amounts owed and preserving TLRA’s positive community image.
Help patients identify eligible financial assistance or, when assistance does not apply, establish acceptable payment arrangements.
Participate in team meetings, communicate work-related ideas and concerns proactively, and help find appropriate resolutions.
Ensure proper reimbursement for services and file appeals timely.
Review accounts and determine appropriate follow-up activities using Six Sigma practices.
Identify underpayments and overpayments and take appropriate action to resolve accounts.
Validate commercial insurance claims to ensure payment according to contract.
Monitor and communicate errors generated by other groups and evaluate them for trends.