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SalaryMINIMUM QUALIFICATIONS:
High School diploma and 4 years’ experience in a patient account environment or related field.
JOB SUMMARY:
Provides service to patients to resolve routine as well as more complex questions and concerns regarding their Physicians’ Billing Services (PBS) and Hospital Patient Financial Services (HPFS) patient account. Acts as the liaison between PBS/HPFS and clinical departments, insurance companies, insurance billing areas and multiple other areas in the resolution of medical reimbursement issues. Assures the patients issues, problems and questions are appropriately and efficiently resolved in a highly patient friendly manner. Conducts high level research and resolves issues delaying the satisfaction of the customer debt and collection of the outstanding customer balance.
ESSENTIAL JOB FUNCTIONS:
- Receives inquiries/complaints from patients via telephone, in person, email, web and correspondence regarding their PBS and/or HPFS accounts.
- Through verbal and written communication, explain complex insurance information to customers/patients.
- Verify eligibility for coverage with government programs and commercial insurance.
- Serve as liaison for patient in contacting third party payers regarding the patient’s questions.
- Utilizing acquired knowledge of third party payers and informational tools available, assist patient in understanding the payer benefits and methodologies.
- Effectively communicate with clinical departments/divisions/clinics personnel or others to assure the efficient handling of a patient inquiry from inception to completion.
- Determines if an adjustment should be made to a patient account (PBS and HPFS) and effects adjustment if appropriate.
- Determines if a refund should be made on a patient account (PBS and HPFS) and effects refund if appropriate.
- Review and resolve credit balance Patient Accounts from various work lists.
- Identify trends from review of accounts and effect changes to prevent reoccurrence of problems.
- Identify, investigate, resolve and escalate, when necessary, payer, system or clinical departmental billing problems.
- Using various work lists and reports, resolve patient account issues including bad address accounts, delinquent accounts to be referred to outside collection agencies, etc.
- Contacts patients with outstanding balances by phone to attempt to secure payment for the balance or establish a payment plan.
- Appropriately documents the patients account with the nature of the inquiry or contact and the action taken.
- Always remain compliant with HIPAA regulations.
- Assists Manager with system testing as needed.
- Adheres to internal controls and reporting structure.
Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a VEVRAA Federal Contractor, UTMB Health takes affirmative action to hire and advance women, minorities, protected veterans and individuals with disabilities.
