Job description

Houston Metro Urology, Houston’s largest and most comprehensive urology group is seeking to join our team. With 20+ physicians, 10 locations, and 130+ employees, HMU specializes in general urology for both men and women, as well as specialty areas such as incontinence, robotic and laparoscopic surgery, management of kidney stone disease, cancer treatment of the genitourinary organs, and more.

HMU is seeking an experienced medical collector to join our team. The ideal candidate will process and file medical claims, post payments and review account receivables to ensure prompt payments.

Responsibilities:

This position is responsible for the following:

• Effectively review and research claims denials and contact payers to verify detailed denial reasons when necessary.
• Contact patients to obtain accurate insurance information.
• Phone appeals & reconsiderations for denied or rejected claims.
• Must be able to identify and communicate denial/rejection trends to management.
• Follow up on all claims from billing through final resolution.
• Correct and identify billing errors and resubmit claims to insurance carriers·
• Review insurance EOB and initiate appeals as necessary·
• Respond to Payer’s request for additional information/documentation· Posting account adjustments as a result of written communication from third parties (i.e., certain contractual adjustments) ·
• Answer incoming calls and assist insurance carriers with their requests· Communicate patient responsibility with the patient·
• Collect on patient balances and/or establish a payment plan·
• Review weekly schedules for patients with upcoming appointments, contact patients and communicate to front desk arrangements made to collect balances·
• Return mail (patient statements) and contact the patient to obtain the correct billing address and/or payment.
• Navigate and research insurance policies & benefits for policy exclusions for patients.
• Navigate and research payer medical reimbursement policies and exclusions.
• Complete request for reconsideration forms while following payer requirements.
• Prepare documentation and file appeals and reconsiderations as appropriate.
• Review and work on all daily correspondence received from patients and payers.
• Must be aware of the timely filing guidelines associated with reconsiderations and appeals for assigned payers.
• Review accounts for accuracy (payments and adjustments)
• Knowledgeable of medical EOBs, patient deductibles and co-pays, and insurance or third-party correspondence.
• Experience working with payer websites.
• Experience in working-aged AR
• EDI transactions/troubleshooting.
• Other assigned duties.

Qualifications and Requirements

• High School Diploma or GED is required.
• 2-5 years of medical billing, collections, and payment posting experience. Urology experience preferred.
• Certified Professional Coder (preferred but not required).

Skills, Knowledge, and Abilities

• Knowledge of CPT Coding, ICD10, and use of appropriate modifiers.
• Experience working on appeals and composing appeal letters.
• Knowledge of bundling and global periods.
• Experience working in Microsoft Word & Excel, Outlook, Teams, & Athena is a PLUS!
• Experience working in medical collections, both insurance and patient
• Knowledge of insurance plans, claims, and billing processes.
• Must have a working knowledge and proficiency in medical terminology.

Benefits:

• Medical, Dental & Vision Insurance.
• Life, and Accident Insurance.
• Paid Time Off (19 days + 10 Holidays).
• 401(k).

Medical Specialty:

• Urology

Physical Setting:

• Clinic/Private practice

Job Type: Full-time

Pay: $16.00 - $22.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Houston, TX 77027: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Salary Requirements

Education:

• High school or equivalent (Required)

Experience:

• Medical collection: 2 years (Preferred)
• ICD-10: 2 years (Preferred)

Work Location: One location

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