Eligibility Specialist II - Revenue Cycle Financial Clearance

Galveston, Texas, United States

New

Business, Managerial & Finance

UTMB Health

Requisition # 2500655

Required Education / Experience:

High school graduate or equivalent. Three years of financial experience or two years patient accounts experience.

Job Description:

Performs follow-up activities on outstanding hospital and physician accounts and assists patients in the Medicaid/SSI application process. Takes necessary action to ensure timely and appropriate reimbursement and/or account resolution.

Essential Job Functions:

• AssistspatientsintheMedicaid/SSIapplicationprocess,convertingunfundedpatientsinto funded patients.

• ActsasaliaisonbetweenthepatientandvariousagenciessuchtheHealthandHumanServicesCommission(HHSC),theSocialSecurityAdministration(SSA),etc.

• Coordinatesandprocessesvariousforms/paperworknecessaryforMedicaid/SSIreimbursement,UTMBadmissions,and/or other relatedforms.

• Maintainsopenand professionalcommunicationwithcustomers,colleaguesandvendors.

• Updatesinformation andentersappropriatecodesinthepatientaccounting system.

• Maintainscomprehensiveknowledgeoftheworkunitassigned.

• Preparesandmaintainsreportsrelatedtojob duties.

• Updatesanddevelopsdepartmentalpoliciesandprocedures.

• Assistsinthetrainingandmentoring ofnewemployees.

• Adherestoestablished policiesand procedures.

• Adherestointernalcontrolsandreporting structure.

• Performsdetailed follow-upactivitiesonassignedaccountsaccordingtoprocedures.

• Resolves outstandingARaccountsat adefinedlevelofproductivity.

• Validates accuracyofpaymentsand/oradjustmentsonaccounts.

• Processesaccountadjustmentsaccording to policyandprocedures.

• Researchesandresolvescreditbalanceaccounts.

• Identifies and/or preparesandprocessesaccountrefunds.

• Responds todailycorrespondence.

• Verifieseligibilityforcoveragewithanycommercialinsurance,governmentorcharityprograms.

• Performsaccountreviews,audits,and/or appeals.

• Performsqualityassurancereviews.

Marginal or Periodic Job Functions:

• Successfullycompletescompetencybasedtrainingandtestingonanannualbasis.

• Prioritizes andcompletesallworkinanaccurate,effectiveandefficientmanner.

• Participatesinteammeetings/activitiesandsupportsthephilosophyandgoalsoftheteamand department.

• Participates inspecialprojects/assignments.

• Readsallannouncementsandrelevantcommunicationsrelatingtojobduties.

• Performsrelateddutiesasrequired.

Work Environment / Location:

Standard hospital, clinical, laboratory and/or office environment

Salary Range:

Actual salary commensurate with experience

Equal Employment Opportunity

UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities.

Compensation