Patient Business Services (PBS) Specialist

MISSION STATEMENT

The University of Texas MD Anderson Cancer Center in Houston is one of the world's most respected centers focused on cancer patient care, research, education and prevention. It was named the nation's No. 1 hospital for cancer care in U.S. News & World Report's 2018 rankings. It is one of the nation's original three comprehensive cancer centers designated by the National Cancer Institute.

SUMMARY

The PBS Specialist provides professional expertise in patient accounting support, account audit, billing records for attorneys and records services, written and verbal communications for the Executive Director-Finance and Director, Operations, Patient Business Services. The primary purpose of the PBS Specialist position in PBS Administration is to assist PBS with patient and internal and external customer inquiries related to patient account matters. This position is responsible for preparing the COBRA premium payments and compiling the supporting documentation. The PBS Specialist ensures that inquiries are handled timely.

KEY FUNCTIONS

Manages Patients' inquiries via the phone or direct patient encounter.

• Performs a variety of complex duties as required to resolve patient and insurance inquiries to encompass thorough research of patient account for both professional and facility billing. Performs detailed audits of accounts.
• Advises patients or insurance carriers verbally or in writing of account status.
• Manages a high volume of complex inquires across all of the patient accounting systems and resolve concerns within 24-48 hours.
• Utilizes critical thinking skills to make judgement on account.
• Assist the advocates' patient concern
• Address My Chart requests and follow up with patients within 24-48 hours
• Load insurance information
• Compile the refund request packages for approval and processing
• Collections on the 90-120 days self-pay (Alpha Split)
• Must be able to perform analysis on all accounting systems assuring billing of total charges, verification of payment postings, contractual adjustments and report valid account information.
• Adheres to the ABC's of customer service at all times by adhering to the greetings established for the department.
• Receives and responds to incoming calls from providers and representatives from insurance companies providing information necessary to expedite claim processing and resolution.
• Follows up on aged balances identified during each encounter with patients and work towards immediate resolution.
• Work the deceased WQ for placement to OGC that meets the $2500.00 qualification
• Must have excellent written and oral communication
• Collection, Documentation, and Job Knowledge
• Advises patients of all aged balances throughout the accounting systems and take actions to collect.
• Documents all communication with the patients clearly and accepts accountability for completion of the inquiry.
• Maintain all assigned work queues by not lagging beyond 30 days with no follow up activity documented.
• Completes payment plan request timely and accurately according to the guidelines established by the department.

• Achieves the annual collection goals established by the department.
• Work independently and deal effectively with stress as a result of heavy workload and the handling of complex patient inquiries.
• Notifies management timely on accounts that indicates delinquency according to the payment plan contract. Must maintain valid credit card information.
• Must be knowledgeable in reviewing balances in the Epic systems for the PB and HB and understands how to add insurance information for billing purposes.
• Prevent PHI/HIPAA violations.
• Attends required training classes required for the department.
• Ability to access resources available to accurately make a decision.

Productivity and QA

• Meets the daily production standard established for the department.
• Must maintain at least achieves on the quarterly report card.

REQUIREMENTS

Experience

Required: Four years of experience in a business office setting to include two years' experience in billing, governmental regulations and/or claims adjustment.

Education

Required: Associate's degree in Business Administration or related field. May substitute required education degree with additional years of equivalent experience on a one to one basis.

Must pass pre-employment skills test as required and administered by Human Resources.

It is the policy of The University of Texas MD Anderson Cancer Center to provide equal employment opportunity without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, disability, protected veteran status, genetic information, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. http://www.mdanderson.org/about-us/legal-and-policy/legal-statements/eeo-affirmative-action.html