Account Representative

Houston Methodist

. Resolve outstanding third-party primary and secondary insurance claims for professional services .

Posted 9/29/2026full-timeHouston • Texas • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in insurance claims resolution, billing processes, and revenue cycle operations, with a strong focus on compliance with HIPAA and PCI regulations. Proficient in analyzing denial trends and collaborating with teams to enhance performance and reduce account aging.

Highest-signal resume keywords

Insurance Claims ResolutionCPT-4, ICD-9, ICD-10, HCPCS CodingBilling and CollectionsRevenue Cycle OperationsExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Insurance Claims ResolutionCPT-4 CodingICD-9 CodingICD-10 CodingHCPCS CodingBilling FunctionsCollections ActivitiesDenial AnalysisAppeals ProcessesRevenue Cycle Fundamentals

Soft Skills

Excellent Communication SkillsNegotiation SkillsAnalytical AbilitiesGood JudgmentAbility to Handle Multiple Tasks

Tools & Technologies

Billing SoftwareClaims Management SystemsElectronic Health Records (EHR)

Industry Keywords

Third-Party PayorMedicareMedicaidManaged CareIPAsTPAsHIPAA CompliancePCI Compliance

About the role

Key responsibilities & impact

Resolve outstanding third-party primary and secondary insurance claims for professional services
Perform collections activities on simple and complex denials and outstanding insurance balances
Provide information regarding denial trends for future prevention
Collaborate with management to reduce account aging through verbal and written communication
Identify denial trends and notify supervisors or managers to prevent future denials
Collaborate with internal CBO departments and Account Managers
Support knowledge sharing, payor and department cross-training, and team members
Complete special projects to improve team performance
Demonstrate expertise in Medicare, Medicaid, commercial payors, and revenue cycle operations
Protect private health and personal information and comply with HIPAA and PCI regulations
Review third-party payor work queues and resolve accounts and denials
Document complete follow-up notes and monitor work quality
Identify, analyze, and escalate accounts receivable collection trends
Meet or exceed follow-up productivity goals
Contact payors and patients to expedite and maximize insurance claim payments
Review accounts to determine steps needed to resolve outstanding denials
Perform billing functions, including claim resubmissions
Create and submit appeals and engage the coding follow-up team when necessary
Stay current on payor collection procedures and industry trends
Pursue continual professional development

Requirements

What you’ll need

High School diploma or equivalent education
Three years of physician billing experience, preferably in a multi-specialty physician practice
Sufficient proficiency in speaking, reading, and writing the English language
In-depth knowledge of CPT-4, ICD-9, ICD-10, and HCPCS coding
In-depth knowledge of third-party payor reimbursement policies and procedures
Understanding of managed care, IPAs, and TPAs
Extensive knowledge of billing, collections, reimbursement, contractual agreements, and appeals processes
Understanding of revenue cycle fundamentals
Ability to handle multiple tasks simultaneously
Excellent communication and negotiation skills
Ability to work independently and interdependently
Good judgment in handling accounts and dealing with patients and insurance companies
Sharp analytical abilities
Proficient computer skills and ability to learn multiple software programs
Ability to remain calm in stressful situations

Benefits

Comp & perks

Full-time employment
Hybrid work arrangement
Business professional attire; no uniform or scrubs required