Patient Account Representative II - Insurance Eligibility and Verifications - Ophthalmology (Remote)

What we do here changes the world. UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.

We are in search of a Patient Account Representative II - Insurance Eligibility and Verifications to join our Revenue Cycle team as part of UTHealth Neurosciences’ Department of Ophthalmology. Each insurance eligibility and verifications representative is responsible for the day-to-day operations for their assigned providers including verifying insurance policy benefit information, obtaining Authorization/ Precertification, prior to the patient's visit or scheduled admission, or immediately following admission. Assisting in identifying problems and ensuring that insurance is accurate on the patient account and ensuring appropriate referrals have been completely and accurately obtained. While maintaining volume productivity, adhering to UTHN-assigned metrics, and upholding the core values of our team. Our group has a passion for creating positive patient interactions, and we are seeking a team member who is dedicated to caring for the well-being of others. This opportunity will also allow for continued growth and development within a multispecialty, comprehensive neurosciences practice.

Location: 6400 Fannin St, Houston, TX 77030 for up to 2 months for training then Virtual/Remote except in special circumstances (meetings, additional training, etc.). Must live in Texas (TX).

Once you join us you won't want to leave. It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus:  

• 100% paid medical premiums for our full-time employees  
• Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year) 
• The longer you stay, the more vacation you’ll accrue! 
• Longevity Pay (Monthly payments after two years of service) 
• Build your future with our awesome retirement/pension plan! 

We take care of our employees! As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as... 

• Free financial and legal counseling 
• Free mental health counseling services 
• Gym membership discounts and access to wellness programs 
• Other employee discounts including entertainment, car rentals, cell phones, etc. 
• Resources for child and elder care 
• Plus many more! 

Position Summary:

The patient account representative is responsible for the timely collection of third party and private pay receivables within regulatory guidelines.  

Position Key Accountabilities:

1.    Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls in order to ensure prompt payment of medical claims.
2.    Reviews incoming correspondence and takes appropriate action. Responds promptly to inquiries.
3.    Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments.
4.    Pursues appeals and takes the necessary steps to bring accounts to resolution.
5.    Analyzes accounts for errors, adjustments and credits, issuing corrected entries when necessary.  Updates account information accordingly.
6.    Communication documentation demonstrates clear action taken on each account as well as what further action is needed to capture payment. Work output is documented clearly, so that various departments involved in resolution can review the account.
7.    Ability to meet departmental standard for quality and productivity.
8.    Other duties as assigned.

Certification/Skills:

Basic knowledge of business office, patient billing, or collection/ reimbursement procedures in a healthcare setting; proficient in MS Office with emphasis in Excel, 10-key and math.

Minimum Education:

High School Diploma or equivalent

Minimum Experience:

Three years hospital/ medical collections experience with understanding of third party reimbursement procedures, as well as state and federal regulations governing healthcare.

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:

This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215

Residency Requirement:

Employees must permanently reside and work in the State of Texas.