Collection Specialist - St. Josephs Medical Center

POSITION SUMMARY:

Under the supervision of the Director of Revenue Cycle or designee, performs patient account follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.

KEY RESPONSIBILITIES:

• Insurance follow-up, as assigned
• Contact insurance carriers regarding outstanding balances until resolution
• Resubmit claims with the appropriate remarks and/or attachments as needed
• File insurance reconsideration letter for payment and/or denial disputes
• Validate accounts for accurate payments, discounts, and contractual adjustments
• Reply to insurance carrier correspondence as appropriate
• Run insurance eligibility and correct claim before resubmission as needed
• Pull supporting documents for annual regulatory audits, as needed
• Ensure credit balance and refund requests are reviewed and resolved timely

• Answer in-coming calls resolving patient and/or insurance issues timely
• Assist with other duties as assigned, within skill sets and abilities

POSITION QUALIFICATIONS: Equal Opportunity Employer Minorities/Women/Veterans/Disabled

• High School graduate or equivalent
• Minimum 1-year Commercial, HMO, PPO, and Workers Compensation billing and/or
• Insurance follow-up experience
• Working knowledge of HMO, PPO, Commercial, and Workers' Compensation reimbursement
• Working knowledge of Managed Care contract language and interpretation

Houston's oldest hospital is GROWING!

Welcome to St. Joseph Medical Center (SJMC), Houston's first and only downtown hospital delivering world-class care for the last 137 years and looking forward to the next century of exceptional care to Houstonians when they need us most.

Whether it's for a scheduled surgery, the birth of a baby, an unexpected emergency, or an outpatient visit, we have staff available around the clock to provide you access to immediate, quality health care. SJMC has been providing health care services to Greater Houston residents for over 130 years, which should give you great comfort in knowing that we have a great tradition of caring for our community. We strive to meet our patients' expectations and encourage our patients to provide us with feedback on how we can help them have the best experience possible while they're in our care.

Over the last years we have expanded our services to include the Advanced Wound Care Center, Comprehensive Cardiac and Vascular Services, the Women's Center, the St. Joseph Maternal Fetal Medicine Center, and a Weight Loss Surgery Program, just to name a few. As you work with our physicians, nurses, case managers, educators, and other staff, you will be guided through your health care journey, from diagnosis to treatment, with compassion every step of the way.

Diversity, equity, inclusion, and belonging are at the foundation of the care St Joseph Medical Center provides to our community we are privileged to support in all of our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or expression or any other non-job-related characteristic.