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Job Information

MD Anderson Cancer Center PBS Associate - Billed Claims in Houston, Texas

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 primary purpose of the PBS Associate position is to follow-up on billed claims within regulatory guidelines. The PBS Associate must ensure that all claims have a follow-up actions according to timely filing limits and that all follow-up activities are performed accurately.

Key Functions

  1. Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls in order to ensure prompt payment of medical claims.

  2. Responds to requests made by third party payors and in a timely manner.

  3. Responds timely to patient account inquires received from customer service.

  4. Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments. Makes recommendations for resolution.

  5. Pursues appeals when available. Initiates communication with coding team and clinical staff when coding related and medical necessity appeals are warranted.

  6. Consistently reviews processes and recommends any areas of opportunities with assigned payors

  7. Written communication demonstrates clear action taken on each account as well as what further action is needed to capture payment. Work output is documented clearly, so that various departments involved in resolution can review the account.

  8. Achieves improved team performance by completing assigned special projects.

  9. Identifies, analyzes and escalates trends affecting AR collections.

  10. Provides verbal and written communication while assisting management in addressing issues with difficult claims and aging.

  11. Facilitates department training by assisting other team members in payor source education and knowledge sharing as requested by Management.

  12. Ability to meet departmental standard for quality and productivity

Physical Demands

Indicate the time required to do each of the following 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

se computer/keyboard

X

Required Education:

High school diploma.

Required Experience:

Three years of experience in billing, insurance follow-up, or collections in a medical or hospital business office setting.

Preferred Experience:

  • 3+ years account follow-up/revenue cycle experience that includes successfully appealing denied claims

  • Analyze, prioritize, problem solve, and follow-through timely on denied claims

  • Epic billing/EMR system experience

  • Thorough understanding of Medicare, Medicaid, Managed Medicare/Managed Medicaid and their reimbursement policies (ex. LCD/NCD).

Work Location:

This position is remote. We are searching for a candidate in the local Houston area only.

Other Requirements:

Must pass pre-employment skills test as required and administered by Human Resources.

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. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html

Additional Information

  • Requisition ID: 167754

  • Employment Status: Full-Time

  • Employee Status: Regular

  • Work Week: Days

  • Minimum Salary: US Dollar (USD) 45,000

  • Midpoint Salary: US Dollar (USD) 56,500

  • Maximum Salary : US Dollar (USD) 68,000

  • 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

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