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PBS Associate - Hospital Billing & Collections
In the Hospital Billing and Collections Department, your role ensures accurate and timely follow-up on medical claims, directly supporting the financial health of the organization and patient care. This is more than a billing position—it’s an opportunity to contribute to a mission-driven team that values precision, collaboration, and excellence.
The ideal candidate for the PBS Associate position is a detail-oriented, proactive professional with strong organizational and communication skills. They thrive in a fast-paced environment, managing multiple priorities while ensuring accuracy and compliance with regulatory guidelines. This individual demonstrates a commitment to excellence in billing and collections, with the ability to identify trends, resolve issues, and collaborate effectively across teams.
Key Attributes of the Ideal Candidate:
- Claims Management Expertise: Skilled in managing work queues, following up on claims, denial management experience, experience using UB-04 (CMS-1450) forms, and engaging payor websites to ensure timely payments.
- Analytical Skills: Capable of identifying denial trends, analyzing accounts receivable issues, and recommending process improvements.
- Communication Mastery: Provides clear, concise written documentation and verbal communication to support resolution and transparency.
- Problem-Solving Ability: Demonstrates initiative in pursuing appeals, resolving discrepancies, and escalating issues when necessary.
- Team-Oriented: Supports departmental training, shares knowledge, and contributes to team success through collaboration.
- Adaptability: Handles changing priorities and complex claims with professionalism and efficiency.
- Quality & Productivity Focus: Consistently meets departmental standards for accuracy and output.
What’s in it for you?
- Paid Medical Benefits: MD Anderson covers 100% of medical benefits for employees, plus dental and vision options.
- Generous Paid Time Off (PTO): Vacation, sick leave, and holidays to help you recharge.
- Retirement Plans: Secure your future with robust retirement programs and employer contributions.
- Professional Growth: Access to training, development programs, and opportunities for advancement.
- Mission-Driven Work: Your efforts help maintain financial integrity and support patient care at one of the nation’s leading cancer centers.
Key Responsibilities
Claims Follow-Up & Resolution
- Manage multiple work queues for follow-up and denials by engaging payor websites and initiating calls to ensure prompt payment of medical claims.
- Respond promptly to requests from third-party payors and patient account inquiries received from customer service.
Denial Management & Appeals
- Identify denial trends and notify leadership to prevent future denials and delays in payment.
- Pursue appeals when available, collaborating with coding teams and clinical staff for coding-related and medical necessity appeals.
Process Improvement & Analysis
- Review processes regularly and recommend improvements for assigned payors.
- Identify, analyze, and escalate trends affecting accounts receivable collections.
Documentation & Communication
- Document all actions clearly on each account, ensuring transparency for other departments involved in resolution.
- Provide verbal and written communication to assist management in addressing issues with difficult claims and aging accounts.
Training & Team Support
- Assist in department training by sharing payor source knowledge and supporting team education.
- Complete assigned special projects to improve team performance.
Quality & Productivity
- Meet departmental standards for accuracy, quality, and productivity in all tasks.
Other Duties
- Perform additional tasks as assigned to support departmental goals.
EDUCATION
- Required: High School Diploma or Equivalent
- Preferred: Associate's Degree Business, healthcare or related field.
WORK EXPERIENCE
- Required: 3 years Experience in billing, insurance follow-up, or collections in a medical or hospital business office setting.
- Preferred: Hospital collections experience including follow up and denial management experience, experience using UB-04 (CMS-1450) forms, insurance verification/authorization, knowledge of CPT codes.
OTHER REQUIREMENTS: Must pass pre-employment skills test as required and administered by Human Resources.
Work Schedule: Remote 100%. Must be flexible for meetings and collaboration if needed onsite. We are looking for applicants in the Houston/local area only.
The University of Texas MD Anderson Cancer Center offers excellent benefits, including medical, dental, paid time off, retirement, tuition benefits, educational opportunities, and individual and team recognition.
This position may be responsible for maintaining the security and integrity of critical infrastructure, as defined in Section 113.001(2) of the Texas Business and Commerce Code and therefore may require routine reviews and screening. The ability to satisfy and maintain all requirements necessary to ensure the continued security and integrity of such infrastructure is a condition of hire and continued employment.
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
