Sr. Patient Account Specialist - Revenue Cycle ...

@ University of Texas Medical Branch (UTMB)

Overview

The Sr. Patient Account Specialist at University of Texas Medical Branch (UTMB) is responsible for billing all third-party payers through a claims processing vendor and/or for appeal of denied professional and/or hospital claims. The role involves identifying billing issues affecting hospital and physician claims/accounts and taking necessary actions to ensure timely and appropriate claim filing and reimbursement.

Essential Job Functions

• Expert understanding of state and federal billing regulations.
• Utilizes knowledge of CPT, ICD-9, HCPCS, modifier coding, and POS requirements.
• Meets or exceeds quality assurance and productivity targets.
• Processes billing for hospital and professional patient accounts.
• Resolves payer rejections daily and performs detailed follow-up on accounts.
• Reviews, researches, processes, and appeals denied claims.
• Updates account data in Epic Resolute and processes adjustments and refunds.

Marginal or Periodic Functions

• Completes competency-based training and testing.
• Prioritizes work with accuracy and efficiency.
• Participates in team meetings and supports departmental goals.
• Assists in training and mentoring new employees.
• Stays updated by reading all job-related communications.

Key skills/competency

Billing, Claims Processing, Epic, Compliance, Coding, Follow-up, Reimbursement, Training, Teamwork, Regulation

Minimum Qualifications

Associate degree or equivalent, minimum three years patient accounts experience, two years Epic Revenue Cycle experience.

Salary Range

Actual salary commensurate with experience.

Equal Employment Opportunity

UTMB Health provides equal employment opportunity and actively promotes affirmative action in hiring and advancement.