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Texas Health and Human Services · 23 hours ago

Reimbursement Officer I

Big Spring, TX

Contract

Onsite

Entry Level

$2,820/mo - $4,149.83/mo

1+ years exp

Texas Health and Human Services is committed to creating a positive impact in the lives of fellow Texans. The Reimbursement Officer I will perform routine reimbursement or claims processing work, maintain files for individuals, and assist in reimbursement audits under moderate supervision.

Health Care

No H1B

Responsibilities

Performs routine reimbursement or claims processing work

Maintains files on each covered individual, gathers all rendered reimbursable services from the individual’s charts for purpose of billing

Maintains a working master list containing Medicare or other third-party payor information on each individual covered

Participates in reimbursement audits

Works under moderate supervision, with limited latitude for the use of initiative and independent judgment

Performs other duties as assigned

Attends work on a regular basis and may be asked 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

Gathers all rendered, reimbursable services for individuals with Medicare or other third-party payor on a monthly basis

Meets with hospital physicians to ensure the codes used are the most accurate for rendered services

Prepares a Monthly Charge Report for individuals with Medicare or other third-party payors, using information pulled from AVATAR and individuals' medical records

Reviews the information for accuracy and makes corrections as necessary using a current Fee Schedule

Enrolls eligible individuals into a Medicare Part D Drug Program that best fits the patient’s needs and enters the information in the online CARE System

Establishes and maintains records on a daily basis, including documents, correspondence, forms, and lists for each patient with Medicare or other third-party payor on campus, as well as maintains an Excel list with information updates as necessary

Prepares Medicare enrollment or revalidation forms for physicians who are employed or contracted by the hospital

Assists in Medicare or other third-party payor audits, and other related work, as required

Performs other duties as assigned. 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

Medicare knowledgeICD-10-CM codingCPT codingElectronic Health RecordsClaims processingOffice equipment useComputer operationCommunication skills

Required

Graduation from a standard senior high school or equivalent or one year experience in claims processing and health-related account and collection work

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

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

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

Flexibility in work hours may be required for this position

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

Compliance with HHSC immunization policy and state hospital operating procedures related to immunizations is required