- Must have knowledge of the UB-04. This includes a working knowledge of modifier logic, HCPCS/CPT codes and revenue line code descriptions.
- Complete claims in daily billing workqueue
- Correct Medicare RTP Billing rejections on-line via Medicare FSS terminal
- Complete daily response & rejection reports
- Process appeals
- Work Medicare denials
- Required to stay abreast of all Medicare Bulletins & Provider Updates on an ongoing basis
- Perform follow-up activity on governmental accounts, to include all accounts on Aged Trail Balance Report, Workqueues and Denials Report. Analyze account by visually reading system comments and billing activities
- Must assure all late and unbilled charges are accounted for and resolved
- Communicates with various revenue departments to validate claim discrepancies
- Communicates with the fiscal intermediary/MAC on claims issues
- Complete claims accurately for patients on CMS Qualified Clinical Trials
- Responsible for notifying management immediately of all rejections and/or problems causing a delay in payments or resolutions of claims. Responsible for notifying Management of any edits or claim corrections needed to expedite payment
- Document clear, concise and complete collection notes in system for each account worked. Assure accounts are worked at a high level of quality and completeness by visually proofreading and monitoring work output. This includes performing system analyzation
- Other duties as assigned.
- Requisition ID: 165314
- Employment Status: Full-Time
- Employee Status: Regular
- Work Week: Days
- Minimum Salary: US Dollar (USD) 58,000
- Midpoint Salary: US Dollar (USD) 72,500
- Maximum Salary : US Dollar (USD) 87,000
- Fund Type: Hard
- Work Location: Remote (within Texas only)
- Pivotal Position: No
- Referral Bonus Available?: No
- Relocation Assistance Available?: No
- Science Jobs: No
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PBS Billing Specialist - Houston, United States - University of Texas M.D. Anderson
Description
Mission StatementThe mission of The University of Texas M. D.
Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.
SummaryThe PBS Billing Specialist provides professional expertise in daily governmental billing and follow-up processes for technical charges.
The primary purpose of the PBS Billing Specialist position is to bill and follow-up on Medicare claims within regulatory guidelines.
The PBS Billing Specialist must ensure that all claims are filed according to timely filing limits and that all follow-up activities are performed timely and accurately.
Key FunctionsThis position requires:
Working in Office Environment
______ No
__X__ Yes
Working in Patient Care Unit (e.g. Nursing unit; outpatient clinic)
__X___ No
______ Yes
Exposure to human/animal blood, body fluids, or tissues
__X___ No
______ Yes
Exposure to harmful chemicals
__X___ No
______ Yes
Exposure to radiation
__X___ No
______ Yes
Exposure to animals
__X____ No
______ Yes
Physical Demands
Indicate the time required to do each of the following physical demands:
Time Spent
Never
0%
Occasionally
1-33%
Frequently
34-66%
Continuously
67-100%
Standing
X
Walking
X
Sitting
X
Reaching
X
Lifting/Carrying
Up to 10 lbs
X
10lbs to 50 lbs
X
More than 50 lbs
X
Pushing/Pulling
Up to 10 lbs
X
10lbs to 50 lbs
X
More than 50 lbs
X
Use computer/keyboard
X
Required Education:
Associate's degree or equivalent college credit.
Required Experience:
Five years of progressively responsible billing experience with three years in governmental hospital billing. May substitute required education degree with additional years of equivalent experience on a one to one basis.
Preferred Experience:
Experience in hospital billing and collections for governmental payors including VA, Tricare, Medicare and Managed Medicare payors, experience with Epic, excellent communication skills.
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law.