BILLING SPECIALIST I
BILLING SPECIALIST I
Posting Number: SRGV3633
Number of Vacancies: 2
Location: Harlingen, Texas
Department: School of Medicine / Clinical Affairs
Scope of Job:
Facilitate the revenue cycle process following patient accounts through entire billing process from charge entry to completion of payment process working within UT Health RGV EMR and with contracted billing agency.
Description of Duties:
• Works closely with Revenue Cycle team, clinics, physicians, departments, and contracted billing agency to resolve issues with insurance companies regarding incorrect registration information, claims processing, coding issues, and AR payments or denials.
• Responsible for accurate and timely resolution of professional billing claim and clearinghouse edits as well as payer rejections/denials.
• Responsible for reviewing physician/provider documentation and assists in assigning ICD10 diagnoses and CPT4 procedure codes for professional charges. This includes assigning modifiers properly for physician/outpatient clinic visits.
• Works with physicians, clinic staff, revenue cycle staff, payers and other departments of UT Health RGV to resolve issues with insurance companies regarding demographic and insurance information, coding issues, and claims processing and proper reimbursement.
• Ensures coding guidelines are followed and ensures all elements of E/M level meet the Medicare guidelines for E/M level assignment.
• Assists in educating physician staff, residents and other clinical staff on coding issues, including medical necessity issues, and coding requirements. Maintains working day-to-day knowledge of electronic health record (EHR).
• Follows up and thoroughly researches reason for denied claims and works appeals as necessary to resolve outstanding balances.
• Identifies and documents new payer denial trends and notifies supervisor for escalated follow-up.
• Performs root cause analysis and identifies edit trends timely to minimize lag delays and maximize opportunities to improve processes.
• Demonstrates good judgment in escalating root causes and edit trends to leadership to ensure timely resolution.
• Communicates effectively with the Coding and Compliance Specialist to handle accurate and timely resolution of coding-related claim edits and appeals.
• Provides customer service to patients by addressing their questions, concerns or complaints. Educates them on insurance policies and billing procedures.
• Runs billing, Accounts Receivable, denials, and any other Revenue Cycle reports as requested or needed.
• Assists in month end procedures and reporting.
• Assists with managing patient and payer credit balances following established Revenue Cycle policy and procedures.
• Performs other duties as assigned.
General supervision from assigned supervisor.
Direct supervision of assigned staff.
High school diploma or equivalent.
RHIA, RHIT, CCS, CPC-P or CCS-P are preferred. Certified Coding certificate as CPC-P or CCS-P from AHIMA or AAPC will be required after 2 years of employment.
• Three (3) years of medical billing experience, including thorough knowledge of the entire claims billing, collections, and reimbursement processes is required, or
• Two (2) years of billing experience with RHIA or RHIT.
Previous coding experience in a multi-specialty practice. Bilingual (English/Spanish).
Use of standard office equipment.
Needs to be able to successfully perform all required duties. Office Environment; some travel and weekend work is required. Must be familiar with CPT4, ICD10, HCPCs codes and use of modifiers. Ability to be flexible with assignments and multi-task as needed. Ability to demonstrate problem-solving skills in dealing with billing and collections related issues. Proficient use of computers and a working knowledge of Microsoft Office.
Excellent verbal and written communication skills are required.
Physical Capabilities: N/A
Employment Category: Full-Time
Minimum Salary: Commensurate with Experience
Posted Salary: Commensurate with Experience
Position Available Date: 11/07/2018
Grant Funded Position: No
If Yes, Provide Grant Expiration Date:
UTRGV is an Affirmative Action/Equal Opportunity Employer that strives to hire without regard to race, color, national origin, sex, age, religion, disability, sexual orientation, gender identity or expression, genetic information or veteran status. UTRGV takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.
Special Instructions to Applicants:
Human Resources will not be held responsible for redacting any confidential information from the documents you attach with your application. The confidential information includes the following:
*Date of Birth
Please make sure that you omit this information prior to submission. We are advising that Human Resources will be forwarding your application to the department as per your submission. The University of Texas Rio Grande Valley reserves the right to discontinue accepting applications prior to the stated close date of this position, after meeting the posting requirement of three (3) calendar days.
If you have any questions, please do not hesitate to contact us at (956)665-2451 and/or [email protected]
UTRGV is a distributed location institution and working location is subject to change based on need.
All UTRGV employees are required to have a criminal background check (CBC). Incomplete applications will not be considered.
Substitutions to the above requirements must have prior approval from the Chief Human Resources Officer.
To apply, visit https://careers.utrgv.edu/postings/19572
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