Reimbursement Officer III

Reimbursement Officer III:

Would you thrive in an environment where you learn and grow personally and professionally all while helping make a positive impact on people's lives? Do you appreciate being around others like yourself who are dependable, trustworthy, hard workers who believe in the value of each other, teamwork, and inclusivity?

HSCS is dedicated to building a diverse community atmosphere where employees feel valued, supported, and accepted while providing specialized care for Texans in need. If providing hope and healing through compassionate, innovative, and individualized care interest you, we welcome your application for the position below.

This position is located at the Regional Clinical Laboratory at Austin State Hospital (RCLA) and works under the supervision of the Laboratory Manager. Work involves coordinating and monitoring billing and collection activities for all RCLA accounts.

The reimbursement officer has the latitude for the use of personal initiative and independent judgment in the development of processes to fulfill position responsibilities. Responsibilities include processing complex claims, interpreting procedural and diagnostic codes, determining proper payment, processing protests and appeals, resolving billing problems and establishing policies and procedures. Work involves determining eligibility, proper rates, maintenance of accounts, and collection of charges utilizing the laboratory information system and client record system billing software.

May train and/or supervise others. Serves as backup for other office and support staff as needed. Essential Job Functions:

Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned.

Maintains the laboratory information system and client record system billing data for accurate and complete billing statements.

Prepares bills using the laboratory information system and submits required documentation to the local accounting department for processing within the first ten days of each month. (20%)

Processes complex claims with knowledge of the principles of accounting and collection by utilizing automated data processing software.

Adjusts bills appropriately based upon reimbursement documentation and fee schedules.

Utilizes current procedural test and diagnostic codes for accurate laboratory reimbursement processes.

Enters laboratory requisitions into the laboratory information system accurately and timely. Selects appropriate test codes for tests ordered by the clinician.

Serves as back up to office staff providing administrative support services as needed or requested. Answers the telephone and routes calls to the appropriate department. Takes accurate phone messages.

Other duties as assigned, including but not limited to actively participating and/or serving in a supporting role to meet the agency's obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. Knowledge Skills Abilities:

Knowledge of principles of accounting and collection.

Knowledge of office practices and administrative procedures.

Knowledge of laboratory information systems and electronic medical record systems.

Knowledge of medical terminology and current diagnostic coding.

Skill in keeping accurate, detailed records.

Skill in interpreting current procedural and diagnostic codes.

Skill in operating basic office equipment including computers, copiers and fax machines.

Skill in utilizing computer software including Microsoft Word, Excel, Outlook and Power Point.

Ability to utilize laboratory billing software.

Ability to process detailed claims to the Centers for Medicare and Medicaid Services.

Ability to follow written and verbal instructions.

Ability to prioritize and organize detailed tasks to maintain required time frames.

Ability to communicate effectively with coworkers and customers.

Ability to work in harmony with other team members. Registration or Licensure Requirements:

High school diploma or GED required. Initial Selection Criteria:

High school diploma or GED. Additional Information:

Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aid, Medication Aide and Employee Misconduct, and HHS OIG list of Excluded Individuals/Entities. Males between the ages of 18-25 must be registered with the Selective Service.

All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Waco Center for Youth applicants must be 21 years of age.

Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours.

Compliance with HHSC immunization policy and state hospital operating procedures related to immunizations is required. According to the Centers for Disease Control and Prevention, healthcare workers are considered to be at significant risk for acquiring or transmitting hepatitis B, measles, mumps, rubella, varicella (chicken pox), tetanus, diphtheria, pertussis (whooping cough), and influenza.

All these diseases are vaccine preventable. As a result, state hospital policy requires employees be vaccinated according to their level of contact with individuals. In the event you choose to not be immunized for the influenza virus, you may be required to wear a mask and take other protective measures.

If you need assistance completing the online application, contact the HHS Employee Service Center at 1-888-894-4747.

HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.

In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747.

If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview. MOS Code:

Note: Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include: 68L, 65A, 65B, HM, 4C0X1. For more information see the Texas State Auditor's Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx

HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.

I-9 Form - Click here to download the I-9 form.

In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747.

If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

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