What are the responsibilities and job description for the Patient Business Services Associate position at MD Anderson?
The University of Texas MD Anderson Cancer Center in Houston is one of the world's most respected centers focused on cancer patient care, research, education and prevention. It was named the nation's No. 1 hospital for cancer care in U.S. News & World Report's 2022-2023 rankings. It is one of the nation's original three comprehensive cancer centers designated by the National Cancer Institute.
The Patient Business Services (PBS) provides MD Anderson Cancer Center, its patients and physicians with professional, accurate, efficient, responsive and compassionate patient accounting services. PBS will assure that fees for services are accurately reimbursed and that all governing billing and collection regulations are closely followed. PBS aims to create a supportive and integrated environment for patients, clinicians and employees throughout the revenue cycle.
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.
The ideal candidate will be an engaged and accountable team player able to work in a remote environment with a thorough understanding of Medicare, Medicaid, Managed Medicare/Managed Medicaid and their reimbursement policies (ex. LCD/NCD).
This position is located in the Texas Medical Center and is Hybrid Onsite/Remote. The work schedule will be Monday - Friday 8AM-4:30PM.
Key Functions
1. Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls 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
WORK EXPERIENCE
OTHER REQUIREMENTS: Must pass pre-employment skills test as required and administered by Human Resources.
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
Additional Information
#LI-Remote
The Patient Business Services (PBS) provides MD Anderson Cancer Center, its patients and physicians with professional, accurate, efficient, responsive and compassionate patient accounting services. PBS will assure that fees for services are accurately reimbursed and that all governing billing and collection regulations are closely followed. PBS aims to create a supportive and integrated environment for patients, clinicians and employees throughout the revenue cycle.
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.
The ideal candidate will be an engaged and accountable team player able to work in a remote environment with a thorough understanding of Medicare, Medicaid, Managed Medicare/Managed Medicaid and their reimbursement policies (ex. LCD/NCD).
This position is located in the Texas Medical Center and is Hybrid Onsite/Remote. The work schedule will be Monday - Friday 8AM-4:30PM.
Key Functions
1. Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls 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: Three years experience in billing, insurance follow-up, or collections in a medical or hospital business office setting. Or
- Preferred: Five years experience in billing, insurance follow-up, collections, cash posting, credit resolution, or bad debt management in a medical or hospital business office setting.
OTHER REQUIREMENTS: Must pass pre-employment skills test as required and administered by Human Resources.
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
Additional Information
- Requisition ID: 178167
- Employment Status: Full-Time
- Employee Status: Regular
- Work Week: Days
- Minimum Salary: US Dollar (USD) 45,500
- Midpoint Salary: US Dollar (USD) 57,000
- Maximum Salary : US Dollar (USD) 68,500
- FLSA: non-exempt and eligible for overtime pay
- Fund Type: Hard
- Work Location: Remote (within Texas only)
- Pivotal Position: Yes
- Referral Bonus Available?: No
- Relocation Assistance Available?: No
#LI-Remote