MD Anderson Cancer Center • Houston, TX 77007
Job #2654891013
Mission Statement
The mission of The University of Texas M. D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.
Summary
The PBS Billing Specialist provides professional expertise in daily governmental billing and follow-up processes for technical charges. The primary purpose of the PBS Billing Specialist position is to bill and follow-up on Medicare claims within regulatory guidelines. The PBS Billing Specialist must ensure that all claims are filed according to timely filing limits and that all follow-up activities are performed timely and accurately.
Key Functions
Must have knowledge of the UB-04. This includes a working knowledge of modifier logic, HCPCS/CPT codes and revenue line code descriptions.
Complete claims in daily billing workqueue
Correct Medicare RTP Billing rejections on-line via Medicare FSS terminal
Complete daily response & rejection reports
Process appeals
Work Medicare denials
Required to stay abreast of all Medicare Bulletins & Provider Updates on an ongoing basis
Perform follow-up activity on governmental accounts, to include all accounts on Aged Trail Balance Report, Workqueues and Denials Report. Analyze account by visually reading system comments and billing activities
Must assure all late and unbilled charges are accounted for and resolved
Communicates with various revenue departments to validate claim discrepancies
Communicates with the fiscal intermediary/MAC on claims issues
Complete claims accurately for patients on CMS Qualified Clinical Trials
Responsible for notifying management immediately of all rejections and/or problems causing a delay in payments or resolutions of claims. Responsible for notifying Management of any edits or claim corrections needed to expedite payment
Document clear, concise and complete collection notes in system for each account worked. Assure accounts are worked at a high level of quality and completeness by visually proofreading and monitoring work output. This includes performing system analyzation
Other duties as assigned.
Working Conditions
Working in Office Environment
______ No
__ X __ Yes
Working in Patient Care Unit (e.g. Nursing unit; outpatient clinic)
__ X ___ No
______ Yes
Exposure to human/animal blood, body fluids, or tissues
__ X ___ No
______ Yes
Exposure to harmful chemicals
__ X ___ No
______ Yes
Exposure to radiation
__ X ___ No
______ Yes
Exposure to animals
__ X ____ No
______ Yes
Physical Demands
Time Spent
Never
0%
Occasionally
1-33%
Frequently
34-66%
Continuously
67-100%
Standing
X
Walking
X
Sitting
X
Reaching
X
Lifting/Carrying
Up to 10 lbs
X
10lbs to 50 lbs
X
More than 50 lbs
X
Pushing/Pulling
Up to 10 lbs
X
10lbs to 50 lbs
X
More than 50 lbs
X
Use computer/keyboard
X
Required Education:
Associate's degree or equivalent college credit.
Required Experience:
Five years of progressively responsible billing experience with three years in governmental hospital billing. May substitute required education degree with additional years of equivalent experience on a one to one basis.
Preferred Experience:
Experience in hospital billing and collections for governmental payors including VA, Tricare, Medicare and Managed Medicare payors, experience with Epic, excellent communication skills.
It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. ~~~
Additional Information
Requisition ID: 165314
Employment Status: Full-Time
Employee Status: Regular
Work Week: Days
Minimum Salary: US Dollar (USD) 58,000
Midpoint Salary: US Dollar (USD) 72,500
Maximum Salary : US Dollar (USD) 87,000
FLSA: non-exempt and eligible for overtime pay
Fund Type: Hard
Work Location: Remote (within Texas only)
Pivotal Position: No
Referral Bonus Available?: No
Relocation Assistance Available?: No
Science Jobs: No
#LI-Remote
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