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 primary purpose of the PBS Associate position is to follow-up on claims within regulatory guidelines. The PBS Associate must ensure that all claims have a follow-up action according to timely filing limits and that all follow-up activities are performed accurately.Key Functions
Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls in order to ensure prompt payment of medical claims.
Responds to requests made by third party payors and in a timely manner.
Responds timely to patient account inquires received from customer service.
Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments. Makes recommendations for resolution.
Pursues appeals when available. Initiates communication with coding team and clinical staff when coding related and medical necessity appeals are warranted.
Consistently reviews processes and recommends any areas of opportunities with assigned payors
Written communication demonstrates clear action taken on each account as well as what further action is needed to capture payment. Work output is documented clearly, so that various departments involved in resolution can review the account.
Achieves improved team performance by completing assigned special projects.
Identifies, analyzes and escalates trends affecting AR collections.
Provides verbal and written communication while assisting management in addressing issues with difficult claims and aging.
Facilitates department training by assisting other team members in payor source education and knowledge sharing as requested by Management.
Ability to meet departmental standard for quality and productivity
Working ConditionsThis position requires:Working in Office Environment No X YesWorking in Patient Care Unit (e.g. Nursing unit; outpatient clinic) X No YesExposure to human/animal blood, body fluids, or tissues X No YesExposure to harmful chemicals X No YesExposure to radiation X No YesExposure to animals X No YesPhysical DemandsIndicate the time required to do each of the following physical demands:Time SpentNever0%Occasionally1-33%Frequently34-66%Continuously67-100%StandingXWalkingXSittingXReachingXLifting/CarryingUp to 10 lbsX10lbs to 50 lbsXMore than 50 lbsXPushing/PullingUp to 10 lbsX10lbs to 50 lbsXMore than 50 lbsXse computer/keyboardXRequired Education:High school diploma.Preferred Education:Associate's degree.Required Experience:Three years of experience in billing, insurance follow-up, or collections in a medical or hospital business office setting.Preferred Experience/Skills:Experience with hospital Insurance/medical claims, hospital billing, insurance verification/authorization, knowledgeable of CPT codes.Other Requirements:Must pass pre-employment skills test as required and administered by Human Resources.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. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.htmlAdditional Information
Requisition ID: 166499
Employment Status: Full-Time
Employee Status: Regular
Work Week: Days
Minimum Salary: US Dollar (USD) 45,000
Midpoint Salary: US Dollar (USD) 56,500
Maximum Salary : US Dollar (USD) 68,000
FLSA: non-exempt and eligible for overtime pay
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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