MD Anderson Cancer Center Patient Business Services - Credit Resolution in Houston, Texas
Patient Business Services - Credit Resolution
Location: United States, Texas, Houston, Houston (TX Med Ctr) at https://mdanderson.referrals.selectminds.com/jobs/13214/other-jobs-matching/location-only
Healthcare/Business Support at http://mdanderson.referrals.selectminds.com/landingpages/healthcarebusiness-support-opportunities-at-md-anderson-cancer-center-12
Finance Division 900134
Requisition #: 117565
We are MD Anderson
The mission of The University of Texas MD 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.
Our vision is to be the premier cancer center in the world, based on the excellence of our people, our research-driven patient care and our science. We are Making Cancer History.
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The 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.
The primary purpose of the PBS Associate position is to work patient accounts in a high volume production environment in the capacity of billing, collections, appeals, cash posting, credit resolution, bad debt and customer service for both hospital and practice plan services. Payor mix on the patient accounts encompasses governmental, managed care, commercial, self-pay, embassy, and charity care. Working knowledge of regulatory and payor guidelines regarding billing, collections, appeals, cash posting, refunds/credit resolution, bad debt and/or charity care is required. Multiple systems used for patient accounting (AR) and other systems to support business office revenue cycle functions (claims scrubber, point-of-service collections, imaging, claims clearinghouses, payor portals, etc...)
· Perform account analysis, maintenance and follow-up activity on insurance, self-pay, bad debt and charity care accounts. Work performed in various patient accounting and other ancillary systems to facilitate billing, collections and account resolution.
· Utilize system reports to prioritize account workload to maximize collection opportunities and enhance accuracy of transactions.
· Analyze governmental, managed care and commercial payments to validate accuracy of payment for services billed. Identify and resolve payor underpayments.
· Contact payers as required to obtain additional information for account resolution, billing, payment, appeals, accurate posting or managed care affiliation.
· Create weekly and monthly departmental AR and specialty reports (i.e. slow pay, spot reports, self-pay, etc.) as they relate to work in progress, penalty requests, backlogs and payor trends.
· Provide assessments and insight with trending reports.
· Identify and work accounts in which underpayments are noted from the payors.
· Process appeals or perform account maintenance as appropriate for payor denials and rejections.
· Track rejections, denials, delayed payments, and/or claims billing or account resolution issues and report to management.
· Document concise and complete accounts notes on every account worked in the appropriate revenue cycle management system. Proofread and QA own work to ensure completeness and accuracy.
· Maintain ongoing, current knowledge of the UB-04 and/or CMS 1500, including, but not limited to modifier logic, HCPCS/CPT codes, and revenue line code descriptions.
· Process primary and secondary claims and late charges
· Thorough understanding of debits and credits and how these are reflected in the respective patient accounting systems.
· Maintain ongoing, current knowledge of all billing regulations and requirements, including, but not limited to commercial insurance requirements, Medicare, and/or Medicaid Bulletins & Managed Care Coverage Policy Updates.
· Update patient demographic and insurance information on accounts and ensure proper claim filing and account balance resolution.
· Advanced ability to read, understand and accurately interpret explanation of benefits and remittance advices.
· Process and post payments, adjustments and denials manually and electronically in respective patient accounting system.
· Reconcile payments and adjustments. Research unidentified payments and credit balance accounts for resolution or return to appropriate party.
· Resolve payment edits.
· Prepare documentation for imaging.
· Working knowledge of business applications (Excel and Word) to be able to create spreadsheets with formulas or charts and memos, letters or other correspondence
· Other duties as assigned.
Required: High School diploma
Preferred: Associates degree
Required: Three years of experience in billing, insurance follow-up, or collections in a medical or hospital business office setting. Must pass pre-employment skills test as required and administered by Human Resources.
Preferred: Five years of experience in billing, insurance follow-up, collections, cash posting, credit resolution, or bad debt management in a medical or hospital business office setting.
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.html