Reimbursement Officer III

TX-HHSC-DSHS-DFPS•Corpus Christi, TX

4d•Onsite

About The Position

Come work in an environment where we truly value and respect those we serve and believe in the mission that all people can achieve a higher level of wellness and independence. The state supported living centers serve people with intellectual and developmental disabilities who are medically fragile or who have behavioral problems. The centers provide campus-based direct services and supports at 13 centers located throughout the state. Learn About Our State Supported Living Centers If you are looking for a place to work where you can establish a career that is filled with purpose, this is the job for you! The Reimbursement Officer III performs professional, technical, and administrative duties necessary to the operations of a large Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). Reimbursement Officer III performs advanced medical billing claim submissions, maintenance of accounts receivable and collection of charges for services provided by the facility. Works under the supervision of the Facility Financial Officer with support services provided by Revenue Management (State Office), exercising a significant degree of initiative and independent judgement in the performance of duties.

Requirements

Considerable knowledge of health-related accounting and collection procedures.
Knowledge of rules and regulations governing reimbursement for agency services.
Proven ability to communicate verbally and in writing in a clear and concise manner, with the ability to direct and instruct.
Ability to work independently, to work cooperatively in a teamwork situation, and to work harmoniously in general with co-workers.
Proven ability to embrace changing conditions and situations in work responsibilities.
Willingness to accept additional responsibility as the need arises.
Reliable in attendance and punctuality.
Ability to work accurately with numbers.
Demonstrate initiative by identifying and solving problems with the ability to make independent and sound technical judgments.
Ability to organize workload and set priorities.
Detail oriented.
Graduation from a standard high school or equivalent is required.
A minimum of two (2) Years experience in claims processing and health-related account and collection work.

Nice To Haves

Experience in use of Microsoft software applications including Word, Excel, and Outlook, preferred.

Responsibilities

Attends work on a regular basis and may be required 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.
Tasks include daily claim submissions, investigating and submitting appeals, posting payments, adjustments and recoupments, and working all aged accounts.
Coordinate and maintain open communication with the Infirmary/Nursing, Medical Records/Admissions and Finance/Accounting Departments in order to accurately submit claims, confirm authorization days and reconcile payments.
May direct, train and cross train less experienced staff within the department, as needed.
As needed, provides facility staff information pertaining to individual's financial status, 3rd party coverage of medical services obtained off-campus and benefits under Social Security, Supplemental Security Income, Veterans Administration, and etc. Completes intake of financial information at time of client's admissions and during follow-up reviews to access for possible source of reimbursement.
Establishes and maintains accounts receivables. Enters financial transactions into the automated data system. Answers inquiries on individual accounts as requested by payors.
Identifies, completes, and arranges application process for benefits from Social Security and Supplemental Security Income programs on behalf of individuals with potential eligibility.
Performs various activities necessary to collect Medicaid, Medicare Part B, and other 3rd party payors reimbursements.
Reconciles monthly cash receipts for both third party and non-third party collections for proper crediting of individual accounts.
Performs office functions including maintenance of files, distribution of daily mail, answering telephone, greeting visitors, word-processing, and photocopying documents.
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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