General Notes
A hybrid work schedule (working onsite and remotely) is available for this position after onsite training and successful performance review have been completed. Must have 3 years of coding and billing experience. Previous experience in Athena a plus.
Purpose
This hybrid position facilitates the day-to-day coordination between facilities and clinical care units to obtain good faith estimate for all services, communicates the surgical estimate to patients, and collects payment. Serves as the liaison between clinical care units, the revenue cycle team, payers, and patients. Assists Clinical Care Units staff and patients with surgical estimate-related questions. This is a pro-active role where you must manage the process to ensure patients receive accurate surgical estimates.
Responsibilities
Interfaces with appropriate ASC or hospital staff to ensure accurate professional, facility and ancillary estimates. Responsible for the accurate and timely creation of good faith estimates for ambulatory surgical center (ASC) and hospital-based surgeries. Utilizes department-specific tools to create good faith estimates and uploads all documentation to the electronic health record.
Accurately calculates patient financial responsibility for services and works with all involved departments to enable timely collections. Follows federal, state and local regulatory requirements related to patient finances. Adheres to established timelines per organizational policy.
Meets or exceeds established performance targets established by the Clinical Revenue Cycle Director.
Performs root cause analyses and identifies trends timely to minimize lag days and maximize opportunities to improve the process and update the Electronic Health Record logic as needed.
Assists the revenue cycle manager a quarterly report of incidents to identify opportunities for improvement. Reports are given to department directors to improve quality of care and billing efficiency.
Demonstrates good judgement in escalating identified root causes and trends to leadership to ensure timely resolution and communication to stakeholders. Assists the revenue cycle manager and compliance officer in the dispute resolution process.
Communicates effectively with the Access Center’s health access partners regarding patient scheduling and related issues.
Communicates effectively with the ASC Business and Clinical, Surgery Scheduling and Coding team on insurance and estimate related issues. Provides customer service to patients by educating them on insurance coverages, authorized services and estimates.
Provides response and assistance to patients via electronic multi-media requests (email, chat, web, etc.).
Maintains working day-to-day knowledge of the EHR and works on special projects related to insurance and authorizations.
Performs other duties as assigned.
Required Qualifications
High school diploma, GED, or equivalent is required. Bilingual in Spanish. A minimum of 3 years of relevant experience required. Previous experience working with an electronic health record (EHR) software and general billing functions. Knowledge of general ambulatory surgical billing procedures. Capable of communicating effectively with patients and the health care team, including the ability to explain billing procedures, insurance benefits to patients and collect high dollar estimates. Knowledge of and/or experience with insurance and authorization for Medicare, Medicaid, commercial, and managed care insurance plans. Knowledge of insurance agency operating procedures and practices. Ability to communicate effectively with payers, providers, and the clinical care units. Professional verbal and written communication. Must respect the confidential nature of medical information. Capable of following established departmental procedures. Capable of using experience and judgement to plan and accomplish goals. Proficient use of computers and a working knowledge of Microsoft Office. Able to read and interpret documents such as charts, safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to function in a fast paced environment. Ability to be flexible with assignments and multi-task as needed. Ability to demonstrate problem solving skills in dealing with insurance and patient estimate issues.
Relevant education and experience may be substituted as appropriate.
Preferred Qualifications
More than the required years of experience in healthcare surgery center billing, deep knowledge of surgery center billing functions, and Athena experience.Knowledge of operating an electronic telephone software system.Bachelor’s degree and/or certification in a relevant field.Experience with Microsoft Teams, REDCap or Smartsheet.
Salary Range
$45,000+ depending on qualifications
Working Conditions
Required Materials
Importantfor applicants who are NOT current university employees or contingent workers:You will be prompted to submit your resume the first time you apply, then you will be provided an option to upload a new Resume for subsequent applications. Any additional Required Materials (letter of interest, references, etc.) will be uploaded in the Application Questions section; you will be able to multi-select additional files. Before submitting your online job application, ensure thatALLRequired Materials have been uploaded. Once your job application has been submitted, you cannot make changes.
Important for Current university employees and contingent workers:As a current university employee or contingent worker, you MUST apply within Workday by searching for Find UT Jobs. If you are a current University employee, log-in to Workday, navigate to your Worker Profile, click the Career link in the left hand navigation menu and then update the sections in your Professional Profile before you apply. This information will be pulled in to your application. The application is one page and you will be prompted to upload your resume. In addition, you must respond to the application questionspresented to upload any additional Required Materials (letter of interest, references, etc.) that were noted above.