The University of Texas Medical Branch Patient Account Specialist - Revenue Cycle HB Billing & Denials in Galveston, Texas

Min Qualifications

High School Diploma or equivalent. Two years of financial experience or one year of patient accounts experience.

Job Summary:

The Patient Account Specialist will be responsible for billing all third party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital claims. Identifies billing issues affecting hospital and/or physicians claims/accounts and takes necessary action to ensure timely and appropriate claim filing. Performs follow-up activities and identifies reimbursement issues affecting these claims. Takes necessary actions to insure timely and appropriate reimbursement and account resolution.

Salary Range

Salary is commensurate with experience

Specific Job Related Duties

ESSENTIAL JOB FUNCTIONS:

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  • Demonstratesalevelofcompetenceandunderstandingofallstateandfederallaws,rules andregulationsregardingpayer billingguidelines

  • Demonstratesabasicunderstanding ofCPT,ICD-9, HCPCS,modifier codingas wellasPOS requirements

  • Billing payersand/orclientsfor hospital and/or Professional Patient Accounts

  • Resolves Payer rejectionsfrombillingsystemdailytobill submithospital and/orphysiciansclaims

  • Performsonlinecorrections toeditedclaimsaccordingtoprocedures

  • Performsdetailed follow-upactivities onassignedaccountsaccordingtoprocedures

  • Responds to dailycorrespondenceaccordingto procedures

  • Identifiesdenialsand underpaymentsfor appeal

  • Reviews, researches and processesdeniedclaims

  • Appealclaims as appropriateaccordingtopoliciesandprocedures

  • Updates accountinformationanddocuments as appropriatewithinEpicResolute

  • Processes account adjustments accordingtopolicies/procedures

  • Issues payer and/orpatientrefunds accordingtopolicies/procedures

  • Validates accuracyofpaymentsand/oradjustmentsonaccounts

  • Resolves outstandingaccounts atrequired accuracy and productivity requirements

  • Maintains comprehensiveknowledgeofthework unit assigned

  • Assists inthe development ofdepartmentpolicies andprocedures

  • Adheres toestablished policies and procedures

  • Adheres tointernal controls andreporting structure

  • Maintainsopenandprofessional communicationwithcustomers, colleagues andvendors

  • Performswellin ateamenvironment

Closing Statement

#csrv

Equal Employment Opportunity UTMB Health strives to provide equal opportunity employment without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or veteran status. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.

Full/Part Time: Full-Time

Job Type: Regular

Job Title: Patient Account Specialist - Revenue Cycle HB Billing & Denials

Job ID: 60353

Location: Galveston

Business Unit: FINCE