Patient Collections Representative Job Houston area,Texas USA,Healthcare

Position: PATIENT COLLECTIONS REPRESENTATIVE
The Patient Collections Representative is responsible for the collection of patient balances for both self-pay accounts and patient responsibility balances following insurance adjudication. This role requires direct interaction with patients through phone, email, and in-person communication.

The representative is responsible for generating, reviewing, and mailing patient statements for assigned facilities within corporate-established time frames. The role requires the ability to explain the medical billing and insurance reimbursement process clearly and professionally while addressing patient questions, complaints, and concerns to resolution.

Minimum Education:
High School Diploma or G.E.D. required.

Required Knowledge & Skills:
Demonstrated understanding of the insurance revenue reimbursement cycle, including payer adjudication, patient responsibility, and post-adjudication collections.
Proven ability to read, analyze, and interpret Explanation of Benefits (EOBs) to determine payment accuracy, denials, adjustments, and patient balances.
Working knowledge of the medical revenue cycle, including patient registration, charge capture, billing, insurance reimbursement, and patient collections.
Familiarity with managing patient accounts and collections while ensuring compliance with billing policies, payer guidelines, and applicable regulations.
Strong computer and keyboarding skills, with the ability to type a minimum of 40 WPM.
Ability to navigate multiple computer systems and software applications while actively communicating by phone.
Proficiency with Windows-based PC applications and the ability to quickly learn new systems and workflows.
Experience with practice management or billing systems; experience with Centricity is beneficial.
Communication & Professional Skills:
Strong verbal and written communication skills with the ability to explain complex billing and insurance information in clear, simple terms.
Demonstrated problem-solving and negotiation skills related to patient balances and reimbursement discrepancies.
Ability to multitask, prioritize responsibilities, and work both independently and collaboratively in a fast-paced environment.
Positive attitude, strong work ethic, and team-oriented mindset.
Willingness to train the proper candidate who demonstrates foundational revenue cycle knowledge.
Bilingual/Spanish-speaking ability is a plus.
Experience:
Minimum of 2 years of experience in customer service, collections, medical billing, or a healthcare revenue cycle-related role preferred.
Prior experience working with self-pay and commercial insurance accounts strongly preferred.

Job Responsibilities / Duties

Answer incoming patient calls and accurately identify the type of assistance needed, including benefits and eligibility, billing and payments, authorizations, and Explanation of Benefits (EOBs).
Ask appropriate questions and actively listen to identify patient concerns while accurately documenting required information in computer systems.
Resolve patient inquiries through to completion in real time, including timely and comprehensive follow-up when required.
Communicate clearly and professionally with patients to ensure full understanding of their bills, statements, and insurance processing.
Initiate collection efforts on all open patient balances via statements, phone calls, and email correspondence, including negotiation when appropriate.
Address patient concerns related to care, costs, and overall billing experience with professionalism and empathy.
Set up, process, and monitor patient payment plans as necessary.
Respond promptly and accurately to written correspondence from patients.
Generate, review, and mail patient statements within corporate-assigned time frames.
Maintain complete, accurate documentation of all collection activities in compliance with HIPAA and company policies.
Stay informed of changes to payer rules, billing guidelines, procedures, and applicable federal and state regulations.
Meet established performance goals related to efficiency, accuracy, quality, patient satisfaction, and attendance.
Perform additional duties as assigned by department management.

Working Conditions

Frequent speaking…


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