Claims Account Representative

Date Posted: Sep 10
Type: Contract
Wage: 19/hr
Job Number: 7049
Location: Houston, TX

TITLE: Claims Account Representative
CLIENT: Hospital
LOCATION: Houston Texas
TYPE: 3 month contract- possible extension
SALARY or RATE: $15-19/hr
URGENCY: Interviewing Now

Seeking a Medical Accounts Representative with collections experience for a 3-month contract role with possibility for extension. This role is open due to an increased workload.

- 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 account notes correspondence.
- 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 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. Provides continual follow-up.
- Assists with special projects to ensure that collection, work queue, and departmental goals are met.


- Our ideal candidate should be well-spoken and well versed in the Insurance/Collections/Appeals process.
- Requires a candidate that has had some longevity in a previous position and recent Collections experience (hospital/facility collections)
- Requires Hospital Insurance Collections experience (Minimum of 2 years).
- 2 years of revenue cycle experience REQUIRED.
- Government Hospital Collections is a PLUS (Traditional Medicaid, Managed Medicaid Plans).
- The best candidates would have experience in larger facilities and have a proven track record of adapting to both quality and productivity standards.
- 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.
- Collections experience is a must

High School Diploma-Required

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