Patient Account Specialist Senior - TLRA Precollect

CHRISTUS Health•Houston, 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 role performs collection follow-up and account resolution and communicates with patients, clients, reimbursement vendors, and other external entities while following client, state, and federal guidelines. Patient and client satisfaction are essential. Associates are expected to understand overall collection workflows for both active accounts receivable and bad-debt inventory. The position handles insurance and self-pay collections, physician billing and collections, account research, appeals, payment arrangements, and reimbursement issues. It documents account activity, supports timely and accurate account resolution, and contributes to team productivity and service standards. The role also uses Six Sigma practices to determine appropriate follow-up, identifies underpayments and overpayments, validates commercial insurance payments against contracts, and monitors errors for trends.

Requirements

High school diploma or equivalent years of experience.
Required experience in a customer service call center environment focused on healthcare billing or collections, or in a collection agency environment.
Strong background in medical collections.
General hospital accounts receivable knowledge.
Solid knowledge and use of desktop applications, including Word and Excel.
Effective communication skills and ability to work as a team member.
Direct knowledge using Meditech and CollectLogix software.

Nice To Haves

3–5 years of experience preferred.
College education, previous insurance company claims experience, and/or healthcare billing trade school education may be considered in lieu of formal hospital experience.

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 accurately and promptly.
Meet daily productivity standards.
Communicate respectfully with patients and/or their families to promote positive patient relations.
Maintain knowledge of payer collection requirements and collect balances from third-party payers in accordance with applicable state and federal laws.
Make thorough, ethical collection efforts and maintain quality standards and appropriate patient accounting documentation.
Contact other departments to obtain information needed for appeals, pending matters, 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.
Assist patients in identifying eligible financial assistance or, when no assistance applies, work with them to arrange acceptable payments.
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 errors for trends.
Complete other special projects as assigned.