At Houston Methodist, the Cash Applications Representative position is responsible for the daily entry, reconciliation, electronic data interchange and analysis of all activity between the bank lockbox and the general ledger. This position monitors all payment sources assigned, including any Electronic Remittance Advices (ERAs) and manual transactions to ensure that all payment transactions received from all payor sources are fully accounted for, accurately credited or debited and balanced daily between the bank account, electronic health record system, and accounting ledgers. This position also monitors all posting software to ensure that all assigned ERAs received will post appropriately. Additionally, this position will work with the Cash Applications Supervisor and/or management to resolve any ERA posting issues.

PATIENT AGE GROUP(S) AND POPULATION(S) SERVED
Refer to departmental "Scope of Service" and "Provision of Care" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.

HOUSTON METHODIST EXPERIENCE EXPECTATIONS

• Provide personalized care and service by consistently demonstrating our I CARE values:
  • INTEGRITY: We are honest and ethical in all we say and do.
  • COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
  • ACCOUNTABILITY: We hold ourselves accountable for all our actions.
  • RESPECT: We treat every individual as a person of worth, dignity, and value.
  • EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.

• Practices the Caring and Serving Model

• Delivers personalized service using HM Service Standards

• Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words)

• Intentionally collaborates with other healthcare professionals involved in patients/customers or employees' experiential journeys to ensure strong communication, ease of access to information, and a seamless experience.

• Involves patients (customers) in shift/handoff reports by enabling their participation in their plan of care as applicable to the given job

• Displays cultural humility, diversity, equity and inclusion principles

• Actively supports the organization's vision, fulfills the mission and abides by the I CARE values

PEOPLE ESSENTIAL FUNCTIONS

• Coordinates with Treasury Management and Financial Accounting to ensure that all debits and credits are accurately reflected in the daily activity.

• Coordinates with Single Billing Office (SBO) and/or AR representatives to resolve cash application discrepancies, as needed.

• Assists with knowledge sharing, payor and department training, and provides support to other team members as advised by the manager and/or supervisor.

SERVICE ESSENTIAL FUNCTIONS

• Works correspondence received in lockbox daily.

• Ensures protection of private health and personal information. Adheres to all Health Insurance Portability and Accountability Act (HIPAA) and Payment Card Industry (PCI) compliance regulations.

• Monitors the appropriate software tools and reports to ensure that assigned electronic remits are accurately posted.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Reviews remittance advices or explanation of benefits received in lockbox correspondence to apply correct contractual adjustment and enters appropriate account status.

• Researches transactions appropriately to ensure that payments are correctly applied. Resolves any pending electronic transactions upon management's request.

• Identifies and resolves unmatched cash transactions in a timely manner. Thoroughly utilizes all available resources to research any potential refund to ensure accuracy and prepares refund requests when appropriate; consistently follows the Levels of Authority (LOA). (EF)

• Completes reconciliation of unidentifiable/unmatched cash receipts. Processes insurance refunds as applicable.

FINANCE ESSENTIAL FUNCTIONS

• Reviews and enters all transactions from work driver rejections/exceptions.

• Resolves assigned reconciling items to ensure the proper statement of cash in financial reports.

• Plays a key role in month end by clearing any assigned tasks for month end and assists with additional research and/or posting as needed to close month properly.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Performs special research and analysis and conducts special projects, with attention to detail and within designated timeframes, as directed by management.

• Actively accommodates new industry technology to maximize work efficiencies.

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

EDUCATION

• High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

WORK EXPERIENCE

• Three years of related experience in patient accounting or institutional/professional cash management, in a high volume, fast paced environment

• Previous experience with electronic remit processing

• Previous experience with bookkeeping or accounting preferred

• Previous experience with an electronic health record system preferred

LICENSES AND CERTIFICATIONS - REQUIRED

• N/A

KNOWLEDGE, SKILLS, AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations

• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security

• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles

• Knowledge of professional and hospital system billing software related to cash posting functions

• Advanced knowledge of the cycle of a patient guarantor account, which will include hospital and physician charges

• Knowledge of hospital and PO billing, collections, reimbursement, contractual agreements and the appeals process, and hospital charity programs

• Excellent communication and negotiation skills, as well as an ability to work independently and interdependently with other business office staff

• Sharp analytical abilities in order to recognize individual patient circumstances and options for resolution

• Proficient computer skills and ability to learn and navigate multiple software programs

• Ability to remain calm in stressful situations with patience and understanding

• Knowledge of medical terminology and applicability

• Ability to multi-task and flexibility to meet the requirements of the department and the organization

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

• Uniform No
• Scrubs No
• Business professional Yes
• Other (department approved) No

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area No
• May require travel outside Houston Metropolitan area No

Houston Methodist Specialty Physician Group - As one of the nation’s leading hospitals and academic medical centers Houston Methodist has brought together some of the nation’s leading experts in multiple specialties to serve our patients.  As part of Houston Methodist Specialty Physician Group (HMSPG), these specialists not only provide excellent clinical care, but are on the forefront of research, developing leading-edge technologies and treatments, and teaching the medical pioneers of tomorrow.  This combination of clinical service, research and academics ensures patients have access to the latest in treatments and technologies while providing the best in comprehensive patient care.  Established as a non-profit corporation and certified by the Texas State Board of Medical Examiners, HMSPG enables physicians to maintain autonomy with respect to their clinical practice while growing their practice within an academic environment.