UTMB Faculty Group Practice · 9 hours ago
Eligibility Specialist II - RCO Financial Clearance
Galveston, Texas, United States
Full-time
Onsite
Mid Level
3+ years expUTMB Health is seeking an Eligibility Specialist II to perform follow-up activities on outstanding hospital and physician accounts and assist patients in the Medicaid/SSI application process. The role involves ensuring timely reimbursement and account resolution while maintaining communication with patients and various agencies.
Hospital & Health Care
Responsibilities
Assists patients in the Medicaid/SSI application process, converting unfunded patients into funded patients
Acts as a liaison between the patient and various agencies such the Health and Human Services Commission (HHSC), the Social Security Administration (SSA), etc
Coordinates and processes various forms/paperwork necessary for Medicaid/SSI reimbursement, UTMB admissions, and/or other related forms
Maintains open and professional communication with customers, colleagues and vendors
Updates information and enters appropriate codes in the patient accounting system
Maintains comprehensive knowledge of the work unit assigned
Prepares and maintains reports related to job duties
Updates and develops departmental policies and procedures
Assists in the training and mentoring of new employees
Adheres to established policies and procedures
Adheres to internal controls and reporting structure
Performs detailed follow-up activities on assigned accounts according to procedures
Resolves outstanding AR accounts at a defined level of productivity
Validates accuracy of payments and/or adjustments on accounts
Processes account adjustments according to policy and procedures
Researches and resolves credit balance accounts
Identifies and/or prepares and processes account refunds
Responds to daily correspondence
Verifies eligibility for coverage with any commercial insurance, government or charity programs
Performs account reviews, audits, and/or appeals
Performs quality assurance reviews
Successfully completes competency based training and testing on an annual basis
Prioritizes and completes all work in an accurate, effective and efficient manner
Participates in team meetings/activities and supports the philosophy and goals of the team and department
Participates in special projects/assignments
Reads all announcements and relevant communications relating to job duties
Performs related duties as required
Qualification
Required
Three years of financial experience or two years patient accounts experience
Company
UTMB Faculty Group Practice
The University of Texas Medical Branch (UTMB) Faculty Group Practice (FGP) is comprised of over 950 faculty physicians and advanced practice providers who drive UTMB’s mission of improving health by delivering innovative education and training, pursuing cutting-edge research, and providing the highest quality patient care.
501-1000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase