Patient Accounts Representative II/ Appeals and Denials - Patient Business Services (90002121)

Baylor College of Medicine

Houston, TX

ID: 7088432 (Ref.No. 9260-en_US)
Posted: November 4, 2021
Application Deadline: Open Until Filled

Job Description


The position requires an experienced collector that understands AR follow up.  The collector should have knowledge of how to appeal a denied claim and check status of a claim by payer website or placing a telephone call to the payer.

Job Duties

  • Assists the AR follow up team with payment reimbursement.
  • Calls insurance companies or access payer website for claim status, appeal status on denied claims and payment reimbursement.
  • Expedites and maximizes payment of insurance medical claims by contacting the patients or insurance companies concerning unpaid accounts receivables via telephone or online systems.
  • Follows up on outstanding accounts and make proper notations (updating insurance information, using correct activity codes) in the Epic system. 
  • Investigates & resolves denials, unpaid accounts, partially paid accounts and requests for information, including appeals. 
  • Reviews invoices to verify payments accurate contractual adjustments. 
  • Updates patient information and file medical claims with correct information, via electronic or paper submission.
  • Assists with inquiries from outside parties regarding account status. 
  • Assists with inquiries from outside parties regarding account status.
  • Resolves all denials, and requests for information, including appeals.
  • Provide guidance and technical work direction to less experienced Patient Account Representatives.

Minimum Qualifications

  • High school diploma or GED.
  • Three years of relevant experience. 

Preferred Qualifications

  • At least three years of AR follow up experience.
  • Experience speaking with the insurance company reps for claim status. 
  • Experience with accessing the payer website for claim information.
  • Experience in submitting an appeal for reimbursement.





Baylor College of Medicine is an Equal Opportunity/Affirmative Action/Equal Access Employer.



Baylor College of Medicine fosters diversity among its students, trainees, faculty and staff as a prerequisite to accomplishing our institutional mission, and setting standards for excellence in training healthcare providers and biomedical scientists, promoting scientific innovation, and providing patient-centered care. - Diversity, respect, and inclusiveness create an environment that is conducive to academic excellence, and strengthens our institution by increasing talent, encouraging creativity, and ensuring a broader perspective. - Diversity helps position Baylor to reduce disparities in health and healthcare access and to better address the needs of the community we serve. - Baylor is committed to recruiting and retaining outstanding students, trainees, faculty and staff from diverse backgrounds by providing a welcoming, supportive learning environment for all members of the Baylor community.