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
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