Reimbursement Operations Specialist (SOD-DB Patient Services)

UT Health

Houston, TX, USA

Full time

Healthcare / Hospital

Nov 8

This job is no longer accepting applications.

Ensures that billable patient charge documents have been correctly coded with standardized coding conventions to obtain optimum reimbursement.

This position will requier the candidate to be a self-starter with a can-do, innovative and forward-thinking mindset; highly adaptable to new knowledge/skills in a fast-paced environment; meticulous attention to detail. Posess knowledge and understanding of insurance benefit plans, claims processing, Explanation of Benefits (EOB). Experience in general Revenue Cycle processes; Proficiency in EMR/EHR systems and software applications, i.e. Microsoft Office, especially Excel. Strong critical thinking and conflict resolution skills; ability to work independently without close supervision. Excellent interpersonal, organizational, verbal and written communication skills.

Position Key Accountabilities:

  1. Reviews insurance company documents to ensure accuracy of reimbursement.
  2. Monitors charges/reimbursements to optimize collection process.
  3. Interfaces with Medicare, Medicaid, and/or insurance companies to handle various problems.
  4. Analyzes fee structures to ensure professional fee billings.
  5. Stays abreast of coding procedures in order to utilize state-of-the-art methods of accurate reimbursement.
  6. Trains various personnel in billing procedures.
  7. Other duties as assigned.


Minimum Education:

High School diploma or equivalent.

Minimum Experience:

Two years of directly related experience in area of specialty.

Physical Requirements:

Exerts up to 50 pounds of force occasionally and/or up to 20 pounds frequently and/or up to 10 pounds constantly to move objects.

Security Sensitive:

This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215

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UT Health

Houston’s health university since 1972.