Account Representative (37285543)

Hi,

Greetings from ObjectWin!

This is Elizabeth with ObjectWin. We have an immediate need for the following requirement. Kindly go through the following job details and If you are interested revert me back with your updated resume or call me back at (346)699-4429

Client name: TCH (Texas Children s Hospital)

Max Pay: $25/hr. on W2 Contract

Job Title: Account Representative (37285543)

Job Location: Bellaire, TX 77401

Job Duration: 3 Months Contract

Shift: Please note, while this is mostly a remote position, training will take place in office for up to 8 weeks. Remote positions require adherence to the Texas Children s Telecommute policy.

Day Shift - Remote with residence in Houston area so that they are able to come to office for training and as needed.

Duties:

Initiates calls or online web contact to payors or guarantors to verify receipt of claims/statements and collect on

outstanding accounts receivables as specified by current collection policies and procedures

Documents follow-up activities, conversations with payors/guarantors, information obtained via the web contact, and any

correspondence in the account notes.

Ensures payments received by third party payors are correct and the correct contractual discounts/allowances have been

applied according to the contract matrix or government reimbursement rates. Ensures that all accounts associated with

that guarantor and payor relationship are resolved.

Analyzes and assesses accounts for outstanding balances and makes prudent decisions on appropriate actions needed to

resolve the balance.

Identifies and reports inaccurate reimbursement and contractual trends to Sr. Reps, Team Lead, or Manager.

Refers problem accounts to Sr. Rep, Team Lead or Manager prior to accounts becoming 60 days old. Documents the issues

in detail and refers to Sr. Rep, Team Lead or Manager with a recommendation of action needed. Provides continual

follow-up.

Assists with special projects to ensure that collection, workqueue, and departmental goals are met.

Skills:

General knowledge of government, commercial and managed care reimbursement methodologies and understanding of all

federal, state, and local legal aspects of collection regulations.

The knowledge of how managed care plans work and the requirements for insurance coverage and benefits.

Ability to communicate effectively both oral and written, good interpersonal skills; decision-making skills; professional

courtesy; the ability to operate a PC and general office equipment.

Account Representatives must have a strong math aptitude in order to be able to verify the appropriate reimbursement

based upon the contract terms, benefits and/or government regulations.

EPIC experience, payer policy review, appeals, denials management, time management, ability to work independently

• Experience in physician services denials management. Specifically, researching payer trends, submitting appeals, tracking denials.
• Training = in-person; remaining is 90% remote. Training = Bellaire office; remaining remote (remote location requires quite location at home where PHI can be protected) Epic (PB), excel, outlook, Availity
• Physician Revenue Cycle and Insurance Collections experience with commercial payers i.e BCBS, UHC, Cigna, and Aetna is required.
• This includes appealing insurance claim denials, underpayments, and understanding root cause analysis of insurance related activities. Billing and general pediatric facilities experience is a PLUS.
• Experience with larger facilities and have a track record of being able to adapt to both quality and productivity standards.
• Applicants who do not have physician insurance collections experience and a minimum of 2 years of current job history will not be considered.
• Experience with Excel and Epic is strongly preferred.

Education:

High School Diploma-Required 2 years revenue cycle experience Required

Skills Required:

MEDICAL COLLECTIONS

Pre-Screenings:

Have they worked Government (Medicare/Medicaid), Commerical (BCBS Aetna United PPO plans etc), or Self Pay collections?

Have they worked Hospital UBs or Professional 1500 claims?

What was their daily quota to meet for worked invoices/accounts, if any?

How were they given daily assignments when doing claim follow up, spreadsheet, a WQ in EPIC, or some other way?

Do they have experience reading and understanding payor policies related to denials?

Are they comfortable writing a detailed appeal letter with payor policy guidelines included?

TCH On boarding Process - Mandatory for all Candidates:

• Minimum 3 weeks needed to complete the on boarding process once offer is accepted
• Must clear the 7 years Criminal Background Investigation
• Education will be Verified by Background Check Agency or the Candidate should be able to provide proof of the minimum Education required as per the job description
• Employment will be Verified by Background Check Agency
• Mandatory Lab Screens (Drug Screen, MMR, Varicella, Tdap and TB Test). Candidates can also share the old screening records so that we can check and then schedule the required screens accordingly
• Candidates cannot start on the assignment without completing the above. We will be scheduling and covering the cost for the above

Thanks & Regards,

Elizabeth R

Executive Recruitment

ObjectWin Technology, Inc.

Phone: (346)699-4429| Email: elizabeth.r@objectwin.com

Global Workforce Solutions | Contingent Staffing | SOW Services | IT Consulting | Certified HUB & MBE Company

19219 Katy Freeway, Suite 275, Houston, TX 77094 | Fax: (713) 782-8283

www.objectwin.com