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PBS Associate - Hospital Collections
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 claims within regulatory guidelines. The PBS Associate must ensure that all claims have a follow-up action 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
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, 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
