Patient Account Specialist Senior - TLRA Support Services

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 assigned for collection. Performs follow-up and account-resolution activities and communicates with patients, clients, reimbursement vendors, and other external entities while complying with client, state, and federal guidelines. Patient and client satisfaction are essential. The role requires knowledge of collection processes for both active accounts receivable and bad-debt inventory. The specialist provides collection services for insurance and self-pay accounts, documents account activity in TLRA’s collection software, responds to patient and carrier inquiries, researches account issues, and works toward established quality, productivity, and recovery goals. The role also supports physician billing and collections by reviewing accounts, pursuing timely appeals, identifying payment discrepancies, validating commercial insurance claims against contracts, and monitoring errors for trends. Other special projects may be assigned.

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 or collections, or in a collection-agency environment, required.
Knowledge of general hospital accounts receivable.
Strong working knowledge of desktop applications, including Word and Excel.
Effective team membership and good communication skills.
No license, registration, or certification required.

Nice To Haves

College education, previous insurance-company claims experience, and/or healthcare billing trade-school education may be considered in lieu of formal hospital experience.
Direct knowledge of Meditech and CollectLogix software.

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 account status accurately and promptly in TLRA’s collection software.
Handle inbound patient and 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 promptly and accurately.
Meet daily productivity standards.
Communicate respectfully with patients and families to promote positive patient relations.
Maintain knowledge of payor collection requirements and collect balances from third-party payers in accordance with applicable state and federal laws.
Conduct thorough, ethical insurance collection efforts and maintain quality standards and proper patient-account documentation.
Contact other departments to obtain information needed for appeals, pending information, and issues affecting or delaying claim processing.
Handle self-pay accounts in a customer-service-oriented manner while collecting amounts due and preserving TLRA’s positive community image.
Help patients identify potential financial assistance or, when assistance does not apply, arrange acceptable payment plans.
Participate in team meetings, communicate work-related ideas and concerns proactively, and help find appropriate resolutions.
Ensure proper reimbursement for services and file appeals on time.
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 terms.
Monitor errors generated by other groups and evaluate them for trends.
Perform other special projects as assigned.