Medical Office Billing Clerk – Intermediate (Customer Service)

UT Health San Antonio is one of the country’s leading health sciences universities and is designated as a Hispanic-Serving Institution by the U.S. Department of Education. With missions of teaching, research, patient care and community engagement, its schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have graduated 39,700 alumni who are leading change, advancing their fields, and renewing hope for patients and their families throughout South Texas and the world.  UT Health San Antonio is a 2021 Forbes Best-In-State Employer and is fast becoming known as a place that launches and advances careers. 

 

As an employer, UT Health San Antonio provides:

•    An excellent benefits package with lower-cost health insurance options for employees as well as competitive dental and vision plans.

•    A defined benefit retirement plan with matching contributions higher than the market average.

•    Three to five weeks of paid time off per year, plus sick leave and paid holidays.

•    Discounts at UT Health providers and facilities.

Job Summary:

Under general supervision in a call center environment, the position will be responsible for performing any combination of routine calculating, posting and verifying duties to obtain primary insurance data for use in preparing statements to patients’ insurance carriers. May prepare notices to patients of amount expected (or received) from insurance and amount expected from patient.

 

Job Duties:

Reviews claims that have been adjudicated by Medicare, Medicaid, and Commercial carriers for appropriate billing.

Addresses denied claims, claims pended for medical necessity, and claims pending for supporting documentation and/or medical records by working with various teams such as clinic staff, registration staff, and coding staff to complete appeals.

Extracts information regarding patient treatment from medical records and works closely with coding staff to compose individualized appeal letters.

Identifies payor specific patterns or trends regarding denials and reports to management for communication to Medical Departments and Administrators.

Makes the necessary recommendations regarding billing and edit creation to reduce denials.

Remains current in all payor specific guidelines.

Utilizes various collection processes such as appeals or collection notices by mail, electronic correspondence, and telephone communication with payor representatives.

Performs all other duties as assigned.

 

Education:

High school diploma or GED is required.

 

Experience:

Three (3) years of related experience including clinical setting is required. Medical/Dental coding and call center experience is preferred.

 

 

Additional Information