Job Description

Responsibilities

ABOUT Texomacare

Our experienced team of physicians is dedicated to caring for all members of the family at every stage of life. TexomaCare is comprised of primary care physicians and a variety of specialists in nine local communities.

Working with TexomaCare means you will work with a care team of physicians, advanced practitioners and staff providing compassionate and quality care.

TexomaCare is proud to be affiliated with Texoma Medical Center (TMC), the Texoma region’s leader in hospital services. Texoma Medical Center is a -bed acute care facility located in Denison, Texas, approximately one hour north of the Dallas / Fort Worth metroplex and just south of the Texas / Oklahoma border.

More than 3, employees, multi-specialty physicians, and over volunteers have helped to support the hospital in delivering quality, patient focused care to the Texoma region for over years.

The Accounts Receivable Specialist is responsible for the accurate and timely follow-up of unpaid claims, by assigned payer / s and defined aging criteria to meet or exceed collection targets and minimize write-offs.

Researches claim denials by assigned payer / s to determine reasons for denials correcting and reprocessing claims for payment in a timely manner.

Meets or exceeds established performance targets (productivity and quality) established by the A / R Supervisor. Initiates and follows-up on appeals recognizing the payer defined aging criteria.

Exercises good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate first pass resolution.

Identifies uncollectible accounts and performs accurate and timely write-offs (e.g. no authorization) adhering to IPM policy guidelines.

Demonstrates the ability to be an effective team player. Upholds best practices in day to day processes and work flow standardization to drive maximum efficiencies across the team.

It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in markets across six states and the District of Columbia.

Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

As a TexomaCare employee you will be part of a first class organization offering :

A Challenging and rewarding work environment

Competitive Compensation & Generous Paid Time Off

Excellent Medical, Dental, Vision and Prescription Drug Plans

K) with company match

About Universal Health Services (UHS), Inc.

Qualifications

Education : High School Graduate / GED required. Technical School / 2 Years College / Associates Degree preferred.

Work experience : Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment.

Knowledge : Healthcare (professional) billing, knowledge of CPT / ICD- coding, government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes.

Understanding of the revenue cycle and how the various components work together preferred.

Skills : Excellent organization skills, attention to detail, research and problem solving ability. Results oriented with a proven track record of accomplishing tasks within a high-performing team environment.

Service-oriented / customer-centric. Strong computer literacy skills including proficiency in Microsoft Office.

Last updated : 2024-04-03