BILLING SPECIALIST II

The University of Texas Rio Grande Valley Job Site; South Valley (NM); Sur place; USD 42 000 - 54 000; Plein temps

Résumé du poste

The University of Texas Rio Grande Valley Job Site is seeking a Billing Specialist II for the School of Medicine / Clinical Affairs. The role focuses on reviewing, coding, and entering charges for oncology services, ensuring accuracy and compliance with payer guidelines in UT Health RGV EMR/PM systems.

You will collaborate with Revenue Cycle teams, physicians, and the billing agency to resolve denials, ensure proper E/M coding per Medicare guidelines, and provide timely posting of payments.

Description du poste

Office Location
The University of Texas Rio Grande Valley
1201 W. University Drive
Human Resources
MASS Building 2 nd Floor
Edinburg, TX 78539

Edinburg: [phone]
Brownsville: [phone]
Office hours:
Monday-Friday
8:00a.m. - 5:00p.m.

Faculty Recruitment:
College of Engineering & Computer Science: [e-mail]

Robert C. Vackar College of Business & Entrepreneurship: [e-mail]

Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening.

Please see Special Instructions for more details.

Dear Applicant, Human Resources will not be held responsible for redacting any confidential information from the documents you attach with your application. The confidential information includes the following: *Date of Birth *Social Security Number *Gender *Ethnicity/Race Please make sure that you omit this information prior to submission. We are advising that Human Resources will be forwarding your application to the department as per your submission. If you have any questions, please visit our Careers site at https://careers.utrgv.edu for detailed contact information.

Position Information

Posting Number

SRGV7124

Working Title

BILLING SPECIALIST II

Number of Vacancies

1

Location

School of Medicine / Clinical Affairs

FTE

1.0

FLSA

Non-Exempt

Scope of Job

Reviews, determines accuracy of and applies the correct coding conventions to patient charge encounters, procedural and surgical services, as defined through physician documentation, regulatory agencies, and various third-party payers for oncology services. To assist with the facilitation of the revenue cycle process following patient accounts through entire process from coding/charge entry to completion of payment process working within UT Health RGV EMR /Practice Management application and with contracted billing agency.

Description of Duties

• Identifies and enters correct code selection from physician documentation, to include, but not be limited to: chart notes, abstracting from medical records documentation, medical diagnostic and/or interventional reports, ensuring compliant coding selections are reported.
• Enters most appropriate Reason for Visit, First Listed Primary Diagnosis, Procedure(s), Modifiers, and all Secondary Diagnosis accurately supports medical necessity and CCI edits.
• Verifies that the final diagnosis reflects the care and treatment rendered to the corresponding code entered.
• Works closely with Revenue Cycle team, clinics, physicians, departments, and contracted billing agency to resolve issues with insurance companies regarding incorrect registration information, claims processing, coding issues, and AR payments or denials.
• Responsible for accurate and timely processing/resolution of coding edits impacting submission of professional claims as well as payer rejections and/or denials.
• Identifies when a physician query is appropriate for further clarification. Recognizes when the documentation is missing or incomplete and routes appropriately. Validates Fee Schedule driven CPT code assignment and routes appropriately. Completes review and final coding when query and/or documentation is available.
• Ensure that patients are charged for all procedures. Reconciles charges against patient schedules.
• Verifies that coding guidelines are followed and ensures all elements of Evaluation & Management (E&M) level meet the Medicare guidelines for E&M level assignment.
• Informs providers of new coding conventions, changes in current coding conventions, and provides feedback on the providers’ coding practices.
• Maintains working day-to-day knowledge of electronic health record ( EHR ) and Practice Management (PM) system.
• Assists in evaluating the medical record for documentation consistency, adequacy, and signature requirements.
• Maintains Coding Quality Standards and Productivity Standard set by UT Health RGV .
• Identifies and documents new payer denial trends and notifies supervisor for escalated follow-up.
• Performs root cause analysis and identifies edit trends timely to minimize lag delays and maximize opportunities to improve processes.
• Communicates regularly and effectively with physicians, clinic staff, and revenue cycle staff for accurate and timely resolution of coding-related claim edits and appeals.
• Provides customer service to patients by addressing their questions, concerns or complaints.
• Responsible for posting payments and adjustments on patient accounts. Reconciles payment/adjustment batches daily.
• Runs billing, Accounts Receivable, denials, and any other Revenue Cycle reports as requested or needed.
• May assist clinics on completing their daily deposits information and ensure their deposit batches are reconciled daily.
• Assists in month end procedures and reporting.
• May assist in registering patient accounts where interfaces are not in place with UT Health partners. This includes entering demographic and insurance information, verifying insurance, entering referral information and/or prior authorization, posting charges and/or payments for clinic visits and/or hospital services.
• May assist clinics on figuring out patient responsibility based on Fee Schedule and/or assisting them in finding the correct CPT code to determine patient responsibility.
• Performs other duties as assigned.

Supervision Received

General supervision from assigned supervisor.

Supervision Given

Direct supervision of assigned staff.

Required Education

• Associate Degree in Healthcare related field or Registered Health Information Technician certified, or
• Two (2) years of the required experience in lieu of associate degree in addition to the required experience.

Preferred Education

None.

Licenses/Certifications

Certified Professional Coder ( CPC ) or Certified Coding Specialist-Physician based ( CCP -P) from American Health Information Management Association ( AHIMA ) or American Academy Professional Coders ( AAPC ).

Required Experience

Three (3) years of medical coding experience, knowledge of the entire claims billing, collections, and reimbursement processes experience in a multi-specialty practice, healthcare facility or ambulatory setting.

Equipment

Use of standard office equipment. Proficient use of computers and a working knowledge of Microsoft Office.

Working Conditions

Needs to be able to successfully perform all required duties. Office Environment; some travel and weekend work is required.

Other

Excellent verbal and written communication skills are required. Must be very familiar with CPT4, ICD10, HCPCs codes and use of modifiers. Ability to be flexible with assignments and multi-task as needed. Ability to demonstrate problem-solving skills in dealing with billing and collections related issues.

Physical Capabilities

N/A

Employment Category

Full-Time

Minimum Salary

Commensurate with Experience

Posted Salary

Commensurate with Experience

Position Available Date

11/06/2023

Grant Funded Position

No

EEO Statement

It is the policy of The University of Texas Rio Grande Valley to promote and ensure equal employment opportunities for all individuals without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or protected veteran status. In accordance with the requirements of Title VII of the Civil Rights Act of 1964, the Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Americans with Disabilities Act of 1990, as amended, our University is committed to comply with all government requirements and ensures non-discrimination in its education programs and activities, including employment. We encourage women, minorities and differently abled persons to apply for employment positions of interest.

Special Instructions to Applicants

Dear Applicant, Human Resources will not be held responsible for redacting any confidential information from the documents you attach with your application. The confidential information includes the following: *Date of Birth *Social Security Number *Gender *Ethnicity/Race Please make sure that you omit this information prior to submission. We are advising that Human Resources will be forwarding your application to the department as per your submission. If you have any questions, please visit our Careers site at https://careers.utrgv.edu for detailed contact information.

Additional Information

UTRGV is a distributed location institution and working location is subject to change based on need.
All UTRGV employees are required to have a criminal background check ( CBC ). Incomplete applications will not be considered.
Substitutions to the above requirements must have prior approval from the VP of HR & Talent Development .

Required fields are indicated with an asterisk (*).

• Are you now, or previously, employed by The University of Texas System or any of its institutions?
  • Yes - I currently am employed by the UT System or its institutions
  • Yes - I have previously been employed by the UT System or its institutions
  • No - I have never been employed by the UT System or its institutions
• Yes
• No
• Please select your highest level of completed education?
  • 6th grade education
  • 10th grade education
  • High School Diploma or GED
  • Associates Degree, Technical, or Trade School Degree/Certification or 60 Hours of College Hours
  • Bachelors Degree from an accredited university
  • Masters Degree from an accredited university
  • Ph. D. or other terminal degree from an accredited university
  • None of the above
• Please provide the field of study for your education:

  (Open Ended Question)

• Please indicate the number of years of work experience you have directly related to the position in which you are applying for:
  • Less than 1 year
  • 1 year
  • 2 years
  • 3 years
  • 4 years
  • 5 years
  • 6 years
  • 7 years
  • 8 years
  • 9 years
  • 10 years
  • Over 10 years
• Do you meet the minimum requirements for this position?
  • Yes
  • No