Patient Services Associate I - Denials
Indexed description
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: Will 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.
- 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.
- 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
- 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.
- 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.
- Ensures compliance with payer guidelines, federal and state regulations, and organizational policies.
- 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
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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