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Texas Health and Human Services · 17 hours ago

Reimbursement Officer III

Corpus Christi, TX

Contract

Onsite

Entry, Mid Level

$3,409.83/mo - $5,094.16/mo

2+ years exp

Texas Health and Human Services Commission (HHSC) is committed to creating a positive impact in the lives of Texans. The Reimbursement Officer III is responsible for performing professional, technical, and administrative duties related to the operations of an Intermediate Care Facility for Individuals with Intellectual Disabilities, including advanced medical billing and maintaining accounts receivable.

Health Care

Responsibilities

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

Tasks include daily claim submissions, investigating and submitting appeals, posting payments, adjustments and recoupments, and working all aged accounts

Coordinate and maintain open communication with the Infirmary/Nursing, Medical Records/Admissions and Finance/Accounting Departments in order to accurately submit claims, confirm authorization days and reconcile payments

May direct, train and cross train less experienced staff within the department, as needed

As needed, provides facility staff information pertaining to individual's financial status, 3rd party coverage of medical services obtained off-campus and benefits under Social Security, Supplemental Security Income, Veterans Administration, and etc. Completes intake of financial information at time of client's admissions and during follow-up reviews to access for possible source of reimbursement

Establishes and maintains accounts receivables. Enters financial transactions into the automated data system. Answers inquiries on individual accounts as requested by payors

Identifies, completes, and arranges application process for benefits from Social Security and Supplemental Security Income programs on behalf of individuals with potential eligibility

Performs various activities necessary to collect Medicaid, Medicare Part B, and other 3rd party payors reimbursements

Reconciles monthly cash receipts for both third party and non-third party collections for proper crediting of individual accounts

Performs office functions including maintenance of files, distribution of daily mail, answering telephone, greeting visitors, word-processing, and photocopying documents

Other duties as assigned include but are 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

Qualification

Claims processingHealth-related accountingAccounts receivable managementMicrosoft ExcelCommunication skillsDetail orientedTeamworkProblem solving

Required

Graduation from a standard high school or equivalent is required

A minimum of two (2) Years experience in claims processing and health-related account and collection work

Considerable knowledge of health-related accounting and collection procedures

Knowledge of rules and regulations governing reimbursement for agency services

Proven ability to communicate verbally and in writing in a clear and concise manner, with the ability to direct and instruct

Ability to work independently, to work cooperatively in a teamwork situation, and to work harmoniously in general with co-workers

Proven ability to embrace changing conditions and situations in work responsibilities

Willingness to accept additional responsibility as the need arises

Reliable in attendance and punctuality

Ability to work accurately with numbers

Demonstrate initiative by identifying and solving problems with the ability to make independent and sound technical judgments

Ability to organize workload and set priorities

Detail oriented

Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aide, Medication Aide and Employee Misconduct and HHS List of Excluded Individuals/Entities (LEIE)

Males between the ages of 18 – 25 must be registered with the Selective Service

All State Supported Living Center Employees are subject to Random Drug Testing

Flexibility in work hours may be required for this position

The position may be required to work overtime and/or extended hours

Must be willing to work weekends and holidays

All applicants must be at least 18 years of age to be considered for employment at a state-operated facility