Patient Account Specialist - Revenue Cycle HB Billing & Denials

　　Galveston, Texas, United States

　　New

　　Business, Managerial & Finance

　　UTMB Health

　　Requisition # 2400298

　　Required Education/Experience:

　　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.

　　Essential Job Functions:

　　• Demonstratesalevelofcompetenceandunderstandingofallstateandfederallaws,rulesandregulationsregardingpayerbillingguideline

　　• Demonstratesabasicunderstanding ofCPT, IC-9,ICD-10,HCPCS,modifiercodingaswellasPOSrequirements

　　• Billing payersand/orclientsforHospitaland/or ProfessionalPatientAccounts

　　• ResolvesPayerrejectionsfrombillingsystemdailytobill submithospitaland/orphysiciansclaims

　　• Performsonlinecorrectionstoeditedclaimsaccordingtoprocedures

　　• Performsdetailed follow-upactivitiesonassignedaccountsaccordingtoprocedures

　　• Respondstodailycorrespondenceaccordingtoprocedures

　　• Identifiesdenialsandunderpaymentsforappeal

　　• Reviews,researchesandprocessesdeniedclaims

　　• Appealclaimsasappropriateaccordingtopoliciesandprocedures

　　• Updatesaccountinformationanddocuments as appropriatewithinEpicResolute

　　• Processes account adjustmentsaccordingtopolicies/procedures

　　• Issuespayerand/orpatientrefunds accordingtopolicies/procedures

　　• Validatesaccuracyofpaymentsand/oradjustmentsonaccounts

　　• Resolves outstandingaccounts atrequiredaccuracyand productivity requirements

　　• Maintainscomprehensiveknowledgeoftheworkunitassigned

　　• Assists inthedevelopmentofdepartmentpoliciesandprocedures

　　• Adherestoestablished policiesandprocedures

　　• Adherestointernalcontrolsandreporting structure

　　• Maintainsopenandprofessionalcommunicationwithcustomers,colleaguesandvendors

　　• Performswellin ateamenvironment

　　Marginal or Periodic Job Functions:

　　• Successfullycompletescompetencybasedtrainingandtesting

　　• Prioritizesandcompletesallworkinanaccurate,effectiveandefficientmanner

　　• Participatesinteammeetings/activitiesandsupportsthephilosophyandgoalsoftheteamanddepartment

　　• Assistsinthetrainingandmentoring ofnewemployees

　　• Readsallannouncementsandrelevantcommunicationsrelatingtojobduties

　　• Performsrelated dutiesasrequired.

　　Preferred Experience:

　　Epic System, Medicaid and Managed Medicaid Hospital Denials and Follow-up.

　　Salary Range:

　　Actual salary commensurate with experience.

　　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