Patient Account Specialist - Revenue Cycle HB Billing & Denials (Galveston)

Company: The University of Texas Medical Branch
Location: Galveston
Posted on: January 27, 2023

Job Description:

Minimum Qualifications: High School Diploma or equivalent. Two years of financial experience or one year of patient accounts experience. Job Description: 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. Job Duties:

• Demonstrates alevelofcompetenceandunderstandingofallstateandfederallaws,rulesandregulationsregardingpayerbillingguidelines
• Demonstrates a basicunderstanding ofCPT, IC-9,ICD-10,HCPCS,modifiercoding aswellas POSrequirements
• Billing payersand/orclientsforHospitaland/or ProfessionalPatientAccounts
• ResolvesPayerrejectionsfrom billing system daily to bill submithospitaland/orphysiciansclaims
• Performsonlinecorrectionstoeditedclaimsaccordingtoprocedures
• Performsdetailed follow-upactivitiesonassignedaccountsaccordingtoprocedures
• Respondstodailycorrespondenceaccording toprocedures
• Identifiesdenialsandunderpaymentsforappeal
• Reviews,researchesandprocessesdenied claims
• Appeal claimsasappropriate according to policies and procedures
• Updatesaccountinformationand documents as appropriate withinEpicResolute
• Processes account adjustmentsaccordingto policies/procedures
• Issuespayerand/or patient refunds according to policies/procedures
• Validatesaccuracyofpaymentsand/oradjustmentsonaccounts
• Resolves outstanding accounts at requiredaccuracyand productivity requirements
• Maintainscomprehensiveknowledgeoftheworkunitassigned
• Assists in thedevelopmentofdepartmentpoliciesandprocedures
• Adherestoestablished policiesandprocedures
• Adherestointernalcontrolsandreporting structure
• Maintainsopenandprofessionalcommunicationwithcustomers,colleaguesandvendors
• Performswellin ateamenvironment
• Successfullycompletescompetencybasedtrainingandtesting
• Prioritizesand completesallworkin anaccurate,effectiveandefficientmanner
• Participatesinteammeetings/activitiesandsupportsthephilosophyandgoalsoftheteamanddepartment
• Assistsin thetrainingandmentoring ofnewemployees
• Readsallannouncementsandrelevantcommunicationsrelatingtojobduties
• Performsrelated dutiesasrequired Preferred Skills: Epic System, Medicaid and Managed Medicaid Hospital Denials and Follow-up. Work Schedule: Monday through Friday 8:00am-5:00pm Salary Range: Actual salary commensurate with experienceEqual Employment Opportunity UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.Compensation

Keywords: The University of Texas Medical Branch, Galveston , Patient Account Specialist - Revenue Cycle HB Billing & Denials (Galveston), Other , Galveston, Texas