The University of Texas Medical Branch Patient Account Specialist - Revenue Cycle HB Billing & Denials in Galveston, Texas
High School Diploma or equivalent. Two years of financial experience or one year of patient accounts experience.
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 is commensurate with experience.
Specific Job Related Duties
ESSENTIAL JOB FUNCTIONS:
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
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
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
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: 60350
Business Unit: FINCE