Hybrid Patient Account Specialist: Claims & Denials Expert

Utmb; Galveston (TX); Hybride; USD 42 000 - 64 000; Plein temps

Résumé du poste

UTMB Health in Galveston, TX is seeking a Patient Account Specialist to bill third-party payers and appeal denied professional and hospital claims. You will identify issues, follow up for timely reimbursements, and ensure accurate claim filing.

The role requires experience with CPT/ICD coding basics, payer guidelines, and effective communication with customers and vendors. Hybrid schedule with on-site expectations as needed.

Qualifications

• Two years of financial experience or one year in patient accounts.
• Experience in hospital billing denials resolution with Medicaid payers.
• Experience in medical billing and revenue cycle operations including claims, EOBs/remits, cash posting, eligibility/registration, coding.
• Experience with multiple payers and using payer websites to obtain claim status.
• Experience using work queues and documenting account notes.
• Strong analytical and problem-solving skills to identify root causes and trends.

Responsabilités

• Billing payers and/or clients for hospital and/or professional patient accounts.
• Resolve payer rejections from billing system daily to bill submit hospital and/or physicians claims.
• Perform online corrections to edited claims according to procedures.
• Perform detailed follow-up on assigned accounts according to procedures.
• Respond to daily correspondence according to procedures.
• Identify denials and underpayments for appeal.
• Review, research, and process denied claims.
• Appeal claims as appropriate according to policies and procedures.
• Update account information and documents within Epic Resolute.
• Process account adjustments and issue refunds according to policies/procedures.
• Maintain comprehensive knowledge of the work unit assigned.

Connaissances

Billing denials Medicaid

Medical billing & RCM

Payer websites

Work queues & notes

Analytical thinking

Financial/patient accounts experience

Description du poste

UTMB Health in Galveston, TX is seeking a Patient Account Specialist to bill third-party payers and appeal denied professional and hospital claims. You will identify issues, follow up for timely reimbursements, and ensure accurate claim filing.

The role requires experience with CPT/ICD coding basics, payer guidelines, and effective communication with customers and vendors. Hybrid schedule with on-site expectations as needed.