Patient Services Associate I - Denials

Job Title

Patient Services Associate I - Denials

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.

Preferred Qualifications

• 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.

Knowledge, Skills, and Abilities

• 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

Responsibilities

Denial Review and Resolution

• 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.

Denial Tracking and Reporting

• 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.

Compliance

• Ensures compliance with payer guidelines, federal and state regulations, and organizational policies.

Why Texas A&M University?

We are a prestigious university with strong traditions, Core Values, and a community of caring and collaboration. Amenities associated with a major university, such as sporting and cultural events, state-of-the-art recreation facilities, the Bush Library and Museum, and much more await you. Experience all that a big city has to offer but with a reasonable cost-of-living and no long commutes.

• 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

Instructions to Applicants: Applications received by Texas A&M University must either have all job application data entered, or a resume attached. Failure to provide all job application data or a complete resume could result in an invalid submission and a rejected application. We encourage all applicants to upload a resume or use a LinkedIn profile to prepopulate the online application.

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.