Sr. Commercial Collector

Houston Methodist•Katy, TX

About The Position

The Senior Commercial Collector protects the organization’s financial viability by securing accurate and timely payments. The position monitors assigned accounts, follows up appropriately, and documents actions taken to maximize collections. It handles higher-dollar accounts, major or complicated payors, and large inventory work queues as directed, and maintains direct contact with Houston Methodist departments and insurance companies. The role participates in meetings and negotiations with Insurance Provider Relations, collaborates with third-party vendors, and serves as a resource, trainer, and mentor to other team members. The Senior Commercial Collector reviews correspondence, responds to payor requests for information, coordinates with Billers as needed, follows up on delinquent insurance claims, analyzes account errors and adjustments, and maintains clear account documentation. The role manages inventory according to departmental standards, identifies accounts for advanced due diligence or legal placement, and works to meet performance expectations. It also stays current on payor procedures and industry trends and contributes ideas to improve quality and service. This is a non-exempt, day-shift position. Business-professional attire or other department-approved attire is required; uniforms and scrubs are not. On-call work may be required during emergencies. The posting states that travel within or outside the Houston metropolitan area is not required.

Requirements

High school diploma or equivalent education.
Five years of experience in commercial insurance follow-up; hospital accounts receivable experience is preferred.
Extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers’ Compensation, and commercial plans.
Knowledge of how to interpret managed care contracts, Medicare, Medicaid, and Workers’ Compensation.
Extensive knowledge of billing, collections, reimbursement, contractual agreements, and the appeals process.
Understanding of revenue cycle fundamentals.
Ability to follow through and handle multiple tasks simultaneously.
Excellent communication and negotiation skills, with the ability to work independently and interdependently with business office staff.
Good judgment in handling accounts and a professional approach to dealing with patients and insurance companies.
Strong analytical abilities to resolve patient accounts accurately and promptly.
Proficient computer skills and ability to learn and navigate multiple software programs.
Ability to remain calm in stressful situations and demonstrate patience and understanding.
Ability to approach problems with an open mind and contribute to solutions.
Strong training, leadership, and mentoring skills.
Sufficient English speaking, reading, and writing proficiency to perform essential job functions, particularly those affecting patient or employee safety or security.
Ability to communicate effectively with patients, physicians, family members, and coworkers using a customer-service focus and positive language principles.
Ability to demonstrate the skills and competencies necessary to safely perform assigned work, as established through ongoing assessments and performance evaluations.

Nice To Haves

Hospital accounts receivable experience.

Responsibilities

Monitor assigned accounts and provide appropriate follow-up and documentation to maximize collection dollars.
Work assigned higher-dollar accounts, major or complicated payors, and large inventory work queues as directed.
Review incoming correspondence, take appropriate action, respond promptly to payor requests for information or documentation, and confer with Billers when clarification is needed.
Participate in meetings and negotiations with Insurance Provider Relations and collaborate with third-party vendors and projects.
Inform the manager of payer trends, changes in payor requirements, and related barriers or problems.
Obtain corrected information and request rebills when needed.
Document every account action clearly and concisely in the collection notes, including the balance breakdown and next responsible party.
Manage inventory according to departmental standards and identify accounts for advanced due diligence or legal placement.
Follow up on assigned delinquent insurance claims and maximize collections in accordance with applicable contracts or Houston Methodist financial arrangements.
Analyze accounts for errors, adjustments, and credits; issue corrected entries when necessary and update account information.
Follow levels of authority for posting adjustments, refunds, and contractual allowances.
Organize time and priorities effectively, use resources efficiently, minimize incidental overtime, and assist other team members during available time.
Serve as a resource and trainer for less experienced and new staff; orient, guide, and mentor team members.
Stay current on payor collection procedures and industry trends, pursue continued learning, and communicate ideas to improve quality or service.
Meet or exceed stated performance indicator expectations, including productivity, account reviews, and aging targets.
Promote a positive, cooperative work environment and maintain professionalism and trustworthiness in interactions.