Sr. Patient Account Specialist - Revenue Cycle HB Billing & Denials

UTMB Health; Galveston (TX); On-site; USD 60,000 - 80,000; Full time

Job summary

An established industry player is looking for a Sr. Patient Account Specialist to join their dynamic team. This role involves handling billing for third-party payers, resolving claim denials, and ensuring compliance with state and federal guidelines. The ideal candidate will have a strong background in patient accounts and Epic Revenue Cycle experience. This position offers the opportunity to work in a collaborative environment where your contributions will directly impact patient care and financial outcomes. If you're passionate about making a difference in healthcare billing, this is the perfect opportunity for you.

Qualifications

• Minimum of three years experience in patient accounts and two years in Epic Revenue Cycle.
• Expertise in state and federal billing laws and guidelines.

Responsibilities

• Responsible for billing third-party payers and appealing denied claims.
• Identifies billing issues and ensures timely claim filing and reimbursement.

Skills

Patient Accounts Experience

Epic Revenue Cycle Experience

CPT Coding

ICD-9 Coding

HCPCS Coding

Billing Guidelines Knowledge

Education

Associate Degree or Equivalent

Tools

Epic Resolute

Job description

For application assistance, please email [e-mail]. Representatives are available Monday through Friday from 8 a.m. to 5 p.m. CST.

Job Description - Sr. Patient Account Specialist - Revenue Cycle HB Billing & Denials (2500652)

Minimum Qualifications
Associate degree or equivalent. Minimum of three years patient accounts experience. Minimum of two years Epic Revenue Cycle experience.

Job Description
The Sr. 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

1. Demonstrates an expert level of competence and understanding of all state and federal laws, rules, and regulations regarding payer billing guidelines.
2. Demonstrates a basic understanding of CPT, ICD-9, HCPCS, modifier coding as well as POS requirements.
3. Meets or exceeds QA and Productivity requirements.
4. Billing payers and/or clients for hospital and/or Professional Patient Accounts.
5. Resolves Payer rejections from billing system daily to bill submit hospital and/or physicians claims.
6. Performs online corrections to edited claims according to procedures.
7. Performs detailed follow-up activities on assigned accounts according to procedures.
8. Responds to daily correspondence according to procedures.
9. Identifies denials and underpayments for appeal.
10. Reviews, researches, and processes denied claims.
11. Appeals claims as appropriate according to policies and procedures.
12. Updates account information and documents as appropriate within Epic Resolute.
13. Processes account adjustments according to policies/procedures.
14. Issues payer and/or patient refunds according to policies/procedures.
15. Validates accuracy of payments and/or adjustments on accounts.
16. Resolves outstanding accounts at required accuracy and productivity requirements.

Marginal or Periodic Functions

1. Successfully completes competency-based training and testing.
2. Prioritizes and completes all work in an accurate, effective, and efficient manner.
3. Participates in team meetings/activities and supports the philosophy and goals of the team and department.
4. Assists in the training and mentoring of new employees.
5. Reads all announcements and relevant communications relating to job duties.
6. Performs related duties as required.

Salary Range
Actual salary commensurate with experience.

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.

Primary Location

United States-Texas-Galveston

Work Locations

1076 - Bank of America Bldg
301 University Blvd. Bank of America Bldg, rm 1.502
Galveston 77555-1076

Job

Business, Managerial & Finance

Organization

UTMB Health

Employee Status

Non-Manager

Job Level

Day Shift

Job Posting

Feb 10, 2025, 3:23:08 PM