Patient Account Specialist - Revenue Cycle PB Billing & Denials
UTMB Health
Patient Account Specialist - Revenue Cycle PB Billing & Denials
**Galveston, Texas, United States**
**New** **Hot**
Business, Managerial & Finance
UTMB Health
Requisition # 2406043
**Patient Account Specialist**
**Minimum Qualifications:**
High School Diploma or equivalent. Two years of financial experience or one year of patient accounts experience.
**Licenses, Registrations, or Certifications:**
High School Diploma or equivalent.
**Preferred Qualifications:**
These are agreed upon during the creation of a new posting with the hiring manager. They need to be verifiable. ( Example: Masters Degree, 5 years of experience )
**Job Summary/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 a level of competence and understanding of all state and federal laws,
rules and regulations regarding payer billing guidelines
• Demonstrates a basic understanding of CPT, ICD-9, HCPCS, modifier coding as well as
POS requirements
• Billing payers and/or clients for hospital and/or Professional Patient Accounts
• Resolves Payer rejections from billing system daily to bill submit hospital and/or
physicians claims
• Performs online corrections to edited claims according to procedures
• Performs detailed follow-up activities on assigned accounts according to procedures
• Responds to daily correspondence according to procedures
• Identifies denials and underpayments for appeal
• Reviews, researches and processes denied claims
• Appeal claims as appropriate according to policies and procedures
• Updates account information and documents as appropriate within Epic Resolute
• Processes account adjustments according to policies/procedures
• Issues payer and/or patient refunds according to policies/procedures
• Validates accuracy of payments and/or adjustments on accounts
• Resolves outstanding accounts at required accuracy and productivity requirements
• Maintains comprehensive knowledge of the work unit assigned
• Assists in the development of department policies and procedures
• Adheres to established policies and procedures
• Adheres to internal controls and reporting structure
• Maintains open and professional communication with customers, colleagues and vendors
• Performs well in a team environment
• Successfully completes competency based training and testing
• Prioritizes and completes all work in an accurate, effective and efficient manner
• Assists in the training and mentoring of new employees
• Reads all announcements and relevant communications relating to job duties
• Performs related duties as required.
• Participates in team meetings/activities and supports the philosophy and goals of the
team and department
**Salary Range:**
Actual salary commensurate with experience or range if discussed and approved by hiring authority.
**Work Schedule:**
Partial remote, onsite position as needed position must be a Texas resident. 8am to 5pm, and as needed on occasion.
**Equal 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
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