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Mission Statement

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.

Summary

The PBS Billing Specialist provides professional expertise in daily governmental billing and follow-up processes for technical charges. The primary purpose of the PBS Billing Specialist position is to bill and follow-up on Medicare claims within regulatory guidelines. The PBS Billing Specialist must ensure that all claims are filed according to timely filing limits and that all follow-up activities are performed timely and accurately.

Key Functions

1. Must have knowledge of the UB-04. This includes a working knowledge of modifier logic, HCPCS/CPT codes and revenue line code descriptions.

2. Complete claims in daily billing workqueue

3. Correct Medicare RTP Billing rejections on-line via Medicare FSS terminal

4. Complete daily response & rejection reports

5. Process appeals

6. Work Medicare denials

7. Required to stay abreast of all Medicare Bulletins & Provider Updates on an ongoing basis

8. Perform follow-up activity on governmental accounts, to include all accounts on Aged Trail Balance Report, Workqueues and Denials Report. Analyze account by visually reading system comments and billing activities

9. Must assure all late and unbilled charges are accounted for and resolved

10. Communicates with various revenue departments to validate claim discrepancies

11. Communicates with the fiscal intermediary/MAC on claims issues

12. Complete claims accurately for patients on CMS Qualified Clinical Trials

13. 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

14. 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

15. Other duties as assigned.

Working Conditions

This position requires:

Working in Office Environment

__ No

_ X _ Yes

Working in Patient Care Unit (e.g. Nursing unit; outpatient clinic)

_ X __ No

__ Yes

Exposure to human/animal blood, body fluids, or tissues

_ X __ No

__ Yes

Exposure to harmful chemicals

_ X __ No

__ Yes

Exposure to radiation

_ X __ No

__ Yes

Exposure to animals

_ X ___ No

__ Yes

Physical Demands

Indicate the time required to do each of the following physical demands:

Time Spent

Never

0%

Occasionally

1-33%

Frequently

34-66%

Continuously

67-100%

Standing

X

Walking

X

Sitting

X

Reaching

X

Lifting/Carrying

Up to 10 lbs

X

10lbs to 50 lbs

X

More than 50 lbs

X

Pushing/Pulling

Up to 10 lbs

X

10lbs to 50 lbs

X

More than 50 lbs

X

Use computer/keyboard

X

Required Education:

Associate's degree or equivalent college credit.

Required Experience:

Five years of progressively responsible billing experience with three years in governmental hospital billing. May substitute required education degree with additional years of equivalent experience on a one to one basis.

Preferred Experience:

Experience in hospital billing and collections for governmental payors including VA, Tricare, Medicare and Managed Medicare payors, experience with Epic, excellent communication skills.

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: 165314

• Employment Status: Full-Time

• Employee Status: Regular

• Work Week: Days

• Minimum Salary: US Dollar (USD) 58,000

• Midpoint Salary: US Dollar (USD) 72,500

• Maximum Salary : US Dollar (USD) 87,000

• FLSA: non-exempt and eligible for overtime pay

• Fund Type: Hard

• Work Location: Remote (within Texas only)

• Pivotal Position: No

• Referral Bonus Available?: No

• Relocation Assistance Available?: No

• Science Jobs: No

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