Administrative Asst I (Reimbursement).
WORK HOURS: MON - FRI, 8:00 AM - 5:00 PM.
Performs advanced technical work in pursuit of reimbursement for services provided to individuals at DSHS facilities. As delegated by the Reimbursement Director, work involves obtaining financial information through conducting a face-to-face interview with individual patients upon admission or on
his/her unit; verifying insurance benefits such as Medicare, Medicaid and individual private insurance, etc., via telephone and or electronic verification systems. Works closely with unit and rehab staff to coordinate and schedule patient interviews. Daily processes and maintains facility patient files, data
entry of insurance benefits in facility automated billing system as well as facility admission log, data entry of bed exemptions as applicable for individuals with insurance. Ability to maintain effective working relationships with individuals served and their representatives, as well as with associates,
supervisors and staff in other departments and other agencies. Works under the general supervision of facility Reimbursement Director with moderate latitude for the use of initiative and independent judgment. Must understand that duties, location of work and shift pattern are subject to change as determined by the administration to meet the needs of the hospital. Requires physical and mental abilities to learn and perform the essential job tasks. Employee actively participates and/or serves in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Must understand that duties, location of work and shift/pattern are subject to change as determined by the administration to meet the needs of the hospital. Must understand that duties may include exposure to blood or other potentially infectious materials. Supports the mission and vision of the facility.
Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Verifies insurance benefits. 20%
Conducts face-to-face financial intake interviews. 30%
Provides appropriate benefit eligibility information to select facility personnel. 25%
Processes and establishes patient account files. 20%
Performs other duties as assigned in order to ensure services are provided. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. 5%
Knowledge Skills Abilities:
Knowledge of various federal and state laws and regulations as it relates to reimbursement of hospital and professional services from the following federal and state programs: Medicare, Medicaid, Social Security, Veterans Administration, Railroad Retirement, Champus, etc. Knowledge of insurance benefit verification. Knowledge of working in a business office or hospital setting related to medical or psychiatric billing. Knowledge of obtaining financial information from mentally challenged consumers and/or individual family members when applicable. Must be computer literate, with advanced skills in Microsoft Word, Excel and Outlook. Knowledge of Medicare and Medicaid web-based verification systems. Ability to maintain effective working relationships with individuals served and their representatives, as well as with associates, supervisors and staff in other departments and other agencies.
Sign Language preferred.
Registration or Licensure Requirements:
Initial Selection Criteria:
Minimum three (3) years of experience with a working knowledge of Medicare, Medicaid, private insurance, insurance HMO's/PPO's, Social Security Administration, Railroad Retirement, Champus, etc., as related to insurance coverage and benefits; verification for reimbursement purposes. Minimum three (3) years of experience interviewing mentally challenged consumers to obtain financial information and insurance benefits, as well as experience working in a psychiatric office or hospital setting.
Computer literate with advanced skills working with Microsoft Word, Excel and Outlook e-mail. Working knowledge of Medicare and Medicaid web-based automated benefit verification systems. Minimum three (3) years of experience working in a business office setting related to medical or psychiatric billing. Ability to maintain professional communication skills with co-workers, supervisor, facility staff and off campus agencies.
WORK HOURS: MON - FRI, 8:00 AM - 5:00 PM.
This position is open only to Health & Human Services employees.
This is a DSHS State Hospital limited client contact position.
Applicant must provide the interviewer with a written explanation of how applicant meets the initial selection criteria. This must be completed and submitted within one (1) business day of the position closing or applicant will NOT be considered for an interview. Submit your explanation to Lisa Dudley either via fax: 903-683-7199 or via e-mail: email@example.com.
In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS employee service center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.req#222437
Texas Department of Family and Protective Services - 17 months ago