Claims Analyst - Indigent Health Care

Fort Bend County • Rosenberg, TX

29d • $18 - $23

About The Position

Fort Bend County is ranked as one of the fastest growing counties in the nation. We have capitalized on not only the creed of our location, but on the "quality of life" for our families to call home. Our employees are the key to our success and the heartbeat of our foundation. The diversity and inclusivity of our community is our strength and at the forefront of a workplace environment welcoming to all. Live Here! Work Here! Inputs claims into the software system; audits claims to ensure that claims are payable and deny ineligible claims. Payable claims are sent to Auditor’s department for review and payment. Processes reimbursement letters to providers requesting services rebilled to Medicaid; process reimbursements received and sent to Treasurer’s office for deposit. Requests additional documents or data needed to make determination of eligibility based on mandated program guidelines. Balances accounts with Auditor’s Office; prepares and submits monthly and annual reports. Assists providers and clients by processing and faxing providers claim status information, answers calls regarding referral information, pre-certification authorizations needed for outpatient surgeries, payment rates, allowed/disallowed procedures and equipment. Discuss correct billing procedures to providers when clients are receiving bills. Conducts weekly audits of claims submitted by Third Party Administrators for payment to ensure claims are paid according to state mandated guidelines. Provides clients with on-going customer service by answering questions and facilitating issue resolutions in the provision of state and local guidelines. Assists other employees with duties when needed, performs other duties and special projects as assigned. Participates in activities and duties related to emergency management during a local state of disaster as directed by appropriate county managers.

Requirements

• High school diploma/GED
• One year job related experience
• Strong computer and typing skills (minimum 30 WPM)
• Excellent analytical, problem solving and communication skills
• Knowledge of medical terminology, billing/collection practices and workflows
• Basic familiarity with Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9), Ninth Edition codes
• Good verbal and written skills
• Strong interpersonal skills and ability to deal effectively with the public, other employees, and elected officials

Nice To Haves

• Associates Degree in Medical Office Administration preferred
• Certification in Medical Coding and Billing preferred
• Ability to maintain current knowledge of specific payer billing requirements and establish effective working relationships with payer representatives preferred

Responsibilities

• Inputs claims into the software system
• Audits claims to ensure that claims are payable and deny ineligible claims
• Payable claims are sent to Auditor’s department for review and payment
• Processes reimbursement letters to providers requesting services rebilled to Medicaid
• Processes reimbursements received and sent to Treasurer’s office for deposit
• Requests additional documents or data needed to make determination of eligibility based on mandated program guidelines
• Balances accounts with Auditor’s Office
• Prepares and submits monthly and annual reports
• Assists providers and clients by processing and faxing providers claim status information
• Answers calls regarding referral information, pre-certification authorizations needed for outpatient surgeries, payment rates, allowed/disallowed procedures and equipment
• Discuss correct billing procedures to providers when clients are receiving bills
• Conducts weekly audits of claims submitted by Third Party Administrators for payment to ensure claims are paid according to state mandated guidelines
• Provides clients with on-going customer service by answering questions and facilitating issue resolutions in the provision of state and local guidelines
• Assists other employees with duties when needed, performs other duties and special projects as assigned
• Participates in activities and duties related to emergency management during a local state of disaster as directed by appropriate county managers.

Benefits

• All full-time and part-time employees are members of the Texas County District Retirement System (TCDRS). Full-time employees also enjoy a wide-range of great benefits.
• Fort Bend County is an equal opportunity employer, committed to non-discrimination in employment on any basis including race, color, religion or creed, sex, sexual orientation, gender, gender identity, gender expression, pregnancy status (including childbirth and related medical conditions), national origin, ethnicity, citizenship status, age (40 and over), physical or mental disability, genetic information, protected military and veteran status, political affiliation or beliefs, or any other classification protected by state, federal and local laws, unless such classification is a bona fide occupational qualification.
• Fort Bend County is committed to providing equal opportunity and reasonable accommodations to employees with disabilities. FBC complies with the Americans with Disabilities Act and all other applicable federal, state and local laws regarding disability discrimination and accommodation.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED