Patient Account Specialist - RCO HB Follow Up

The University of Texas Medical Branch

Galveston (TX)

On-site

USD 45,000 - 65,000

Full time

2 days ago
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Job summary

The University of Texas Medical Branch is seeking a Patient Account Specialist to bill third-party payers through a claims processing vendor and/or appeal denied claims. The role requires identifying billing issues affecting hospital and physician claims, performing follow-up, and ensuring timely reimbursement.

On-site position in Galveston, TX, with standard hours. The incumbent will work within state and federal payer guidelines, using CPT/ICD-9/HCPCS knowledge to ensure accurate submissions

Qualifications

  • Two years of financial experience or one year of patient accounts experience.
  • Two years of financial experience or one year of patient accounts experience.
  • Role-specific experience in healthcare billing, revenue cycle, or medical collections is preferred.

Responsibilities

  • Bill third-party payers for hospital and professional accounts.
  • Follow up on denied claims and appeal as needed.
  • Verify payer guidelines and process claims in Epic Resolute.

Skills

Financial experience
Patient accounts
Healthcare billing

Tools

Epic Resolute

Job description

  • Two years of financial experience or one year of patient accounts experience.
EDUCATION & EXPERIENCE:
  • Two years of financial experience or one year of patient accounts experience.
Minimum Qualifications:
  • Two years of financial experience or one year of patient accounts experience.
Preferred Qualifications:
  • Role-Specific Experience:1-3+ years of experience in healthcare billing, revenue cycle, or medical collections.
  • Payer Knowledge: Strong understanding of Medicare, Medicaid, and major commercial insurance claim filing guidelines.
  • Payer Portals: Experience utilizing insurance web portals to verify claim status, access provider manuals, and review reimbursement methodologies.
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 ensure timely and appropriate reimbursement and account resolution.

ESSENTIAL JOB FUNCTIONS:
  • 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
Marginal or Periodic Functions:
  • 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.
WORKING ENVIRONMENT/EQUIPMENT:
  • Standard hospital, clinical, laboratory and/or office environments.
  • Standard office equipment.
SALARY RANGE:

Actual salary commensurate with experience.

WORK SCHEDULE:

On-site, Monday through Friday, 8 AM - 5 PM.

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 Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.

Primary Location

United States-Texas-Galveston

Work Locations

1022 - Bank of America Bldg

Job

Business, Managerial & FinanceRegular

Employee Status

Non-Manager

Job Level

Day Shift

Job Posting

Oct 19, 2026, 9:06:50 PM

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