Apply on Employer Site

Texas Children's Hospital · 1 week ago

Senior Reimbursement Specialist

Bellaire, TX

Full-time

Onsite

Senior Level

7+ years exp

Texas Children's Hospital is a leading healthcare provider focused on patient care, education, and research for children and women. The Senior Reimbursement Specialist will design and manage databases for denial and underpayment, monitor reimbursement trends, and provide reports to management to improve collections and reduce denials.

EducationHealth Care

H1B Sponsor Likely

Responsibilities

Creates and maintains denial and underpayment databases to ensure that all denied and underpaid accounts are identified and trended to improve collections and reduce denials

Assists Patient Account Managers with training in resolving reimbursement issues related to managed care and other discounted accounts

Meets with payers to maintain productive relationships with the insurance companies, managed care organizations, and government agencies to resolve reimbursement and slow payment problems

Provides weekly, monthly, and annual reports for Business Service Leadership and VP of Finance to manage and monitor Accounts Receivable and Revenue Cycle

Provides period audits on accounts by payer to ensure that accounts are reimbursed appropriately, and contractual discounts are recorded accurately

Develops reimbursement reports for the Health Centers and Learning Support centers

Works closely with Decision Support team to ensure that reimbursement and collections data is accurate

Develops and maintains positive relationships with physicians, providers, and practice managers throughout the delivery system

Actively participates in the development and implementation of the action plans for the department in response to Business Services adoption of Continuous Quality Improvement

Qualification

Claims processing knowledgeManaged care payment plansAccounting experienceProvider relations experienceCommunication skills

Required

High School Diploma or GED

7 years of experience in accounting, contracting, collections, provider relations, or patient access area

A Bachelor's degree may substitute for 4 years of the required experience

Knowledge of State, Federal, and third-party claims processing and the laws of the State Insurance Board and Fair Collection Act

Understand all types of managed care payment plans such as HMO's, PPO's, POS, and EPO plans

Company

Texas Children's Hospital

Glassdoor3.9

Texas Children’s Hospital is a world-class pediatric facility, nationally recognized as a top children’s hospital.

Founded in 1954

Houston, Texas, USA

10001+ employees

http://texaschildrenspeople.org/

H1B Sponsorship

Texas Children's Hospital has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (9)

2024 (18)

2023 (9)

2022 (12)

2021 (11)

2020 (12)