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.
The PBS Specialist provides professional expertise in daily governmental follow-up processes for technical charges. The primary purpose of the PBS Specialist position is to follow-up on Managed Medicare claims within regulatory guidelines. The PBS Specialist must ensure that all claims are filed according to timely filing limits and that all follow-up activities are performed timely and accurately.
1.Must have knowledge of the UB-04. This includes a working knowledge of modifier logic, HCPCS/CPT codes and revenue line code descriptions.
3.Work Managed Medicare denials and follow-up.
4.Required to stay abreast of all Medicare Bulletins & Provider Updates on an ongoing basis.
5.Perform follow-up activity on governmental accounts, to include all accounts on Aged Trail Balance Report, Workqueue and Denials Report. Analyze account by visually reading system comments and billing activities.
6.Maintain appropriate follow-up on appealed claims and contact information.
7.Communicates with various revenue departments to validate claim discrepancies.
8.Communicates with the payors on claims issues.
9.Responsible for notifying management immediately of all rejections and/or problems causing a delay in payments or resolutions of claims. Responsible for notifying Management of any edits or claim corrections needed to expedite payment.
10. Document clear, concise and complete collection notes in system for each account worked. Assure accounts are worked at a high level of quality and completeness by visually proofreading and monitoring work output. This includes performing system analyzation.
11. Other duties as assigned.
Required: Four years of experience in a business office setting to include two years' experience in billing, governmental regulations and/or claims adjustment.
Required: Associate's degree in Business Administration or related field. May substitute required education degree with additional years of equivalent experience on a one to one basis.
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
Requisition ID: 129836
Employment Status: Full-Time
Employee Status: Regular
FLSA: exempt and not eligible for overtime pay
Work Week: Days
Fund Type: Hard
Pivotal Position: Yes
Minimum Salary: US Dollar (USD) 38,800
Midpoint Salary: US Dollar (USD) 49,500
Maximum Salary : US Dollar (USD) 60,200
University Of Texas M.D. Anderson