Reimbursement Officer III- Statewide Billing Team
About The Position
Would you thrive in an environment where you learn and grow personally and professionally all while helping make a positive impact on people’s lives? Do you appreciate being around others like yourself who are dependable, trustworthy, hard workers who believe in the value of teamwork? HSCS is dedicated to building an atmosphere where employees feel valued and supported while providing specialized care for Texans in need. HSCS is comprised of nine psychiatric hospitals, one youth residential treatment facility, and thirteen state supported living centers. The psychiatric hospitals are a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The Joint Commission. They provide state-of-the-art treatment that is recovery-oriented and science-based. If providing hope and healing through compassionate, innovative, and individualized care interests you, we welcome your application for the position below. Performs hospital patient reimbursement work, primarily work involves billing commercial insurance companies, Medicaid MCOs and Medicaid for charges for the support, maintenance, and treatment provided to hospital patients. Works under limited supervision, with considerable latitude for the use of initiative and independent judgment. Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
Requirements
- Knowledge of the principles of psychiatric hospital reimbursement and claim procedures, and of the rules and regulations for billing and claims for clinical services provided by the state.
- Skill in calculating obligations based upon a published set of rules or contract provisions; and in the use of general office equipment, computers, and applicable computer software.
- Ability to communicate effectively to ensure adequate clinical documentation for billings is obtained and provided as necessary to support claims.
- Minimum of two (2) years of experience as a Reimbursement Officer II OR two (2) years of experience in the billing/reimbursement operations for a direct care provider.
Nice To Haves
- Experience in billing for inpatient psychiatric services is preferred.
- Experience with local, state, and federal laws and regulations relevant to a public entity is preferred.
Responsibilities
- Attends work on a regular basis and may be asked to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned.
- Conducts reviews of patient files to ensure treatment complies with Medicaid regulations to ensure appropriate reimbursements for the all the hospitals in the state hospital system.
- Determines amounts to be charged for care and treatment based on treatment and care provided and terms of commercial insurance coverage or Medicaid rules.
- Determines proper payment, collection of charges, and issuance of payment on claims for all the state hospitals in the state psychiatric hospital system for commercial insurers, Medicaid MCOs and Medicaid.
- Establishes charges and creates claim batches in the electronic health records system.
- Resolves billing problems with electronic claim batches to ensure the submission of "clean claims".
- Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
Benefits
- Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
