Fort Bend County · 5 hours ago
Claims Analyst - Indigent Health Care
Rosenberg, TX
Full-time
Onsite
Entry Level
$18.31/hr - $22.89/hr
1+ years expFort Bend County is one of the fastest growing counties in the nation, focusing on quality of life for families. They are seeking a Claims Analyst to manage claims processing, ensure compliance with state guidelines, and provide customer service to clients and providers.
Government Administration
Responsibilities
Inputs claims into the software system; audits claims to ensure that claims are payable and deny ineligible claims. Payable claims are sent to Auditor’s department for review and payment
Processes reimbursement letters to providers requesting services rebilled to Medicaid; process reimbursements received and sent to Treasurer’s office for deposit
Requests additional documents or data needed to make determination of eligibility based on mandated program guidelines
Balances accounts with Auditor’s Office; prepares and submits monthly and annual reports
Assists providers and clients by processing and faxing providers claim status information, answers calls regarding referral information, pre-certification authorizations needed for outpatient surgeries, payment rates, allowed/disallowed procedures and equipment. Discuss correct billing procedures to providers when clients are receiving bills
Conducts weekly audits of claims submitted by Third Party Administrators for payment to ensure claims are paid according to state mandated guidelines
Provides clients with on-going customer service by answering questions and facilitating issue resolutions in the provision of state and local guidelines
Assists other employees with duties when needed, performs other duties and special projects as assigned
Participates in activities and duties related to emergency management during a local state of disaster as directed by appropriate county managers
Qualification
Required
High school diploma/GED
One year job related experience
Strong computer and typing skills (minimum 30 WPM)
Excellent analytical, problem solving and communication skills
Knowledge of medical terminology, billing/collection practices and workflows
Basic familiarity with Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9), Ninth Edition codes
Good verbal and written skills; strong interpersonal skills and ability to deal effectively with the public, other employees, and elected officials
Preferred
Associates Degree in Medical Office Administration
Certification in Medical Coding and Billing
Ability to maintain current knowledge of specific payer billing requirements and establish effective working relationships with payer representatives
Benefits
Members of the Texas County District Retirement System (TCDRS)
A wide-range of great benefits
Company
Fort Bend County
Fort Bend County
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Nicole Ledet, MA-HRD, SHRM-CP, PHR
Director of Human Resources/Chief Human Resource Officer
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