Patient Services Associate I - Denials

About this role

Job Title Patient Services Associate I - Denials

Agency Texas A&M University Health Science Center

Department Clinic Str Finance Centralized

Proposed Minimum Salary Commensurate

Job Location Bryan, Texas

Job Type Staff

Job Description Our Commitment  

Texas A&M University is committed to enriching the learning and working environment by promoting a culture that respects all perspectives, talents   & lived   experiences. Embracing varying opinions and perspectives strengthens our   core   values   which are: Respect, Excellence, Leadership, Loyalty, Integrity, and Selfless Service.       

Who we are As one of the fastest-growing academic health centers in the nation,   Texas A&M Health   encompasses five colleges and   numerous   centers and institutes working together to improve health through transformative education, innovative   research   and team-based health care delivery.  

What we want The Patient Services Associate I reviews, analyzes, and resolves denied or underpaid insurance claims, ensuring timely reimbursement and identifying trends to reduce future denials.   What you need to know Salary:   W ill be   commensurate   based on the selected hire’s education and experience .    

Location/Schedule:  Bryan, TX/Full-Time     

Apply!  Submitting a cover letter, CV/Resume to   assist   us with the review process. You may upload these documents   on   the application under CV/Resume.    

Required Education and Experience • High school diploma or equivalent combination of education and experience.

• Two years of related experience in clinical billing, claims processing, or accounts receivable.

Preferred Qualifications • Four years of related experience in denial management, medical billing, coding, or revenue cycle operations.

• Experience with denial resolution processes.

•  Experience with Epic EMR

• Extensive understanding of medical billing, insurance guidelines, and Texas Medicaid.

• Familiarity with electronic medical record systems, specifically Epic.

Knowledge, Skills, and Abilities • Expertise in denial management, appeals processes, and claims resolution

• Knowledge of HIPAA guidelines and working knowledge of electronic medical record systems (such as Epic)

• Knowledge of word processing and Microsoft Excel spreadsheet applications

• Effective verbal and written communication skills

• Strong interpersonal, problem solving, and organizational skills

• Strong attention to detail and ability to utilize sound judgment

• Ability to work independently and cooperatively with others  

Responsibilities Denial Review and Resolution • Reviews and analyzes denied or underpaid claims to determine root cause and appropriate resolution.

• Prepares and submits timely appeals, including gathering supporting documentation and medical records.

• Follows up with insurance companies on denied claims to ensure timely reconsideration and reimbursement.

• Corrects and resubmits claims as necessary in accordance with payer requirements.

• Documents all denial activities, actions taken, and outcomes in the billing system.

Denial Tracking and Reporting • Monitors denial trends and identifies recurring issues impacting reimbursement.

• Maintains denial logs and prepares reports for management review.

• Communicates trends and recommends process improvements to reduce future denials.

Compliance • Ensures compliance with payer guidelines, federal and state regulations, and organizational policies.

  Why Texas A&M University?  

We are a prestigious university with strong traditions, Core Values, and a community of caring and collaboration.     Amenities associated with a major university, such as sporting and cultural events,   state-of-the-art   recreation facilities, the Bush Library and Museum, and much more await you.     Experience all that a big city has to offer but with   a reasonable   cost-of-living and no long commutes.      

• Medical,   prescription drug,   dental,   vision,   life and AD&D,   flexible spending accounts ,   and long-term disability insurance   with Texas A&M contributing to employee health and basic life premiums   

• 12-15 days   of annual paid holidays    

• Up to   eight hours of paid sick leave   and at least   eight hours of paid vacation   each month   

• Automatic enrollment in the   Teacher Retirement System of Texas     

• Health and Wellness:   Free exercise programs and release time    

• Professional Development: All employees have access to free   LinkedIn Learning   training, webinars, and limited financial support to attend conferences, workshops, and more    

• Educational release time and tuition assistance   for completing a degree while a Texas A&M employee   

• Living Well,   a program at Texas A&M that has been built by employees, for employees   

Instructions to Applicants:   Applications received by Texas A&M University must either have all job application data entered, or a resume attached. Failure to provide all job application data or a complete resume could result in an invalid submission and a rejected application. We encourage all applicants to upload a resume or use a LinkedIn profile to prepopulate the online application. 

All positions are security-sensitive. Applicants are subject to a criminal history investigation, and employment is contingent upon the institution’s verification of credentials and/or other information required by the institution’s procedures, including the completion of the criminal history check.

Equal Opportunity/Veterans/Disability Employer.

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