Note: The job is a remote job and is open to candidates in USA. The University of Texas Medical Branch is hiring a Patient Account Specialist to bill and follow up on third-party payer claims and appeal denied professional and hospital claims. The role identifies billing and reimbursement issues, takes action to support timely claim filing and payment, and resolves patient accounts.

Responsibilities

• 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
• Participates in team meetings/activities and supports the philosophy and goals of the team and department
• Assists in the training and mentoring of new employees
• Reads all announcements and relevant communications relating to job duties
• Performs related duties as required

Skills

• Two years of financial experience or one year of patient accounts experience
• Experience with patient account follow-up, including contacting insurance payers to obtain claim status updates
• Experience researching and resolving insurance claim denials
• Experience using Epic Resolute preferred

Benefits

• Flexible scheduling between 7:00 AM and 5:00 PM.
• Primarily remote, with occasional onsite attendance required in Galveston, TX, for training, meetings, and other departmental needs.

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