Patient Business Service - Revenue Collections Department
Company: University of Texas MD Anderson Cancer Center in Houston
Location: TX
Category: Healthcare, Professional, Collections, Administrative / Clerical
Job Type: Full Time
Pay Amount: $34,000 to $53,000 / Year
Posted: 4/12/2019
JOB DESCRIPTION:

This position is in the Patient Business Service - Revenue Collections Department.


The PBS Associate is responsible for contacting health insurance plans and/or other third-party payors to determine status on medical claims. This area works with additional units within the Division of Finance in order to resolve issues impacting payment. These areas include Charge Capture, Coding, Billing, Service Documentation/Cash, Credit Resolution, as well as Customer Service. Resources required for successful job performance include but are not limited to: on-line payor web sites, telephone, excellent verbal and written communication, xerox machine, fax machine, computer keyboard and other office equipment as required.

 

KEY FUNCTIONS

  • Performs insurance follow-up activities through the use of a workfile, reports and/or internal/external requests. The individual in this role will make contact with insurance carriers through the use of an automated response system, by speaking with a customer service representative, or via the health plan's secure on-line website. Using effective, investigative skills to obtain clear information as it relates to pricing networks, precertification/authorization information, and the mode of submitting claims with insurance carriers' filing/ appeal deadlines. Productivity quotas and quality of work guidelines should be consistently achieved.
  • Monitor assigned accounts for payment and account resolution through the use of assigned resources. Must set follow-up activities based on the status of the claim.
  • Identify and prepare adjustment requests based on results of account analysis and the review of supporting documentation obtained by reviewing system comments, explanation of benefits, or resources currently being used for this process.
  • Identify and prepare appeal letters for invoices deemed to have been underpaid as it relates to the managed care contractual agreements.
  • Communication and coordination of clinical and financial assessments as it relates to overall account analysis.
  • Establish and maintain effective working relationships and communication with faculty, executives, internal departments, co-workers and patients. Must be able to get the job done energetically and responds positively to changes of day-to-day operations and willingly initiates any action needed for account resolution. Associate should be knowledgeable of medical terminology (and know how to use coding tool resources). Works independently and deals effectively with stress as a result of heavy workload.
  • Document clear, concise and complete activities in system for each account worked using keyboard. Assure accounts have insurance updated at a high level of quality and completeness by visually proofreading and monitoring work output.
  • Formulate and execute decisions based on sound independent judgment and good investigational, research problem-solving and analytical skills.
  • Knowledge of Microsoft Office products, predominantly Microsoft Excel and Microsoft Word.
  • Identification and investigation of system problems, preparing documentation and communication to appropriate personnel.
  • Communicate ideas and suggestions to improve unit procedures, personnel and/or unit efficiency by providing verbal and written communication. Must maintain a high level of knowledge and expertise and will maximize the use of proactive skills and resources. Use creative skills for AR strategies for the maximization of insurance collections.
  • Performs other duties as assigned by supervisor and/or appropriate personnel by required deadlines.

 

JOB REQUIREMENTS:

EDUCATION

Required: High school diploma.

Preferred: Associate's degree.


EXPERIENCE

Required: Three years of experience in billing, insurance follow-up, or collections in a medical or hospital business office setting.


OTHER

Required: Must pass pre-employment skills test as required and administered by Human Resources.

 

 

Minimum Salary: US Dollar (USD) 34,000

Midpoint Salary: US Dollar (USD) 43,500

Maximum Salary : US Dollar (USD) 53,000

ADDRESS:

TX
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