Patient Account Specialist - RCO PB Follow-Up (Hybrid Remote | Galveston)

University of Texas Medical Branch (UTMB)•Galveston, TX

2h•Hybrid

About The Position

The Patient Account Specialist is responsible for billing third-party payers through a claims processing vendor and/or appealing denied professional and hospital claims. The role identifies billing issues affecting hospital and physician claims or accounts and takes action to support timely, appropriate claim filing. The specialist performs follow-up activities, identifies reimbursement issues, and takes necessary steps to secure timely reimbursement and resolve accounts. The position is primarily remote, with occasional onsite attendance in Galveston, Texas, for training, meetings, and other departmental needs. The work schedule is Monday through Friday, with eight-hour shifts scheduled flexibly between 7:00 AM and 5:00 PM. Salary is commensurate with experience.

Requirements

Two years of financial experience or one year of patient accounts experience.
Understanding of state and federal laws, rules, and regulations regarding payer billing guidelines.
Basic understanding of CPT, ICD-9, HCPCS, modifier coding, and place-of-service (POS) requirements.
Ability to prioritize and complete work accurately, effectively, and efficiently.
Ability to maintain professional communication and work effectively in a team environment.

Nice To Haves

Experience with patient account follow-up, including contacting insurance payers for claim status updates.
Experience researching and resolving insurance claim denials.
Experience using Epic Resolute.

Responsibilities

Bill third-party payers and/or clients for hospital and professional patient accounts.
Resolve payer rejections from the billing system daily so hospital and physician claims can be submitted.
Make online corrections to edited claims according to procedures.
Perform detailed follow-up activities on assigned accounts and respond to daily correspondence according to procedures.
Identify denials and underpayments for appeal; review, research, process, and appeal denied claims as appropriate.
Update account information and documentation in Epic Resolute.
Process account adjustments and issue payer and/or patient refunds according to policies and procedures.
Validate the accuracy of account payments and adjustments.
Resolve outstanding accounts while meeting required accuracy and productivity standards.
Maintain comprehensive knowledge of the assigned work unit and assist with developing department policies and procedures.
Adhere to established policies, procedures, internal controls, and reporting structure.
Maintain open, professional communication with customers, colleagues, and vendors, and work effectively in a team environment.
Complete competency-based training and testing; prioritize and complete work accurately, effectively, and efficiently.
Participate in team meetings and activities, support team and department goals, and assist with training and mentoring new employees.
Read announcements and relevant communications related to job duties and perform related duties as required.