"Sr Bill Clk/Pat Acct Rep Hlth"

Our Revenue Cycle team is looking for a highly motivated Senior Billing Clerk/Patient Account Representative to join our Medicaid/Medicaid HMO Hospital Billing Team.

Responsible for accurate claim submission, resolve complex insurance inquiries and reimbursement issues; monitor and analyze outstanding insurance receivables with responsibility for ensuring optimal reimbursement.

• Your primary duties will include claim submissions, error corrections and insurance collections.
• You will initiate and process claims and other forms within prescribed guidelines; screening for accuracy completeness and conformity to required standards.
• You will investigate discrepancies and take appropriate corrective action when necessary ensuring compliance
• Move payments to accounts ensuring appropriate payment catergory, reimbursement level, contractural adjustment and liablility transfer.
• Investigate claim denials and reimbursement issues, pursuing appropriate corrective actions including status of accounts, write-offs, refunds, transfers, and billing third party carriers within established guidelines.
• Monitor, interpret and advise management regarding payer system and reimbursement changes and trends.
• You will contact appropriate third party representatives for information and assistance with denied or incorrectly paid claims.
• Initiate and prepare standardized and ad hoc reports and correspondence based on respective area needs.
• Represent the unit with limited authority regarding general administrative and operational matters on an as need basis.
• Respond to complex billing and collections, financial, or operation inquiries third parties and other customers. Home Infusion billers will periodically respond to patient phone calls and process credit card payments.
• Assist in development of unit policies and procedures including identification and testing of potential billing solutions.
• Once your training is complete, you will assist in training new team members.
• Attend applicable training program initiatives which include but are not limited to MPAA sessions, third party seminars, and in-house training.

Required Qualifications

• High school diploma or equivalent combination of education and experience
• Proficiency in use of computers and software, including Microsoft office products and email/calendar programs.
• Excellent verbal and written interpersonal skills.
• Ability to handle multiple items at a time
• Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, Federal, State and local requirements and JCAHO standards.
• Ability to respect and protect confidential information, work in a team environment, build trust in the working relationships with other staff and faculty, and work independently.
• Knowledge of medical insurance reimbursement policies and procedures.
• Demonstrated ability to work independently.
• Demonstrated attention to details.
• Demonstrated problem solving abilities are necessary.
• Demonstrated ability to handle multiple items simultaneously and produce high-quality work in a timely, accurate and efficient manner.
• Direct experience related to hospital or professional billing, which may include recent completion of a medical billing program.

Desired Qualifications

• Knowledge of University Health System policies, procedures and regulations.
• Experience with University systems including MiChart/Epic, Outlook, as well as, NThrive, Epremis, CHAMPS, Webdenis and other payer websites.
• 2 or more years of billing experience
• Hospital billing experience within last 5 years.
• Deep understanding of ICD-10, CPT, HCPCS codes.
• Complete understanding of coordination of benefits
• Experience with documenting audits for code appropriateness.
• Solid understanding of hospital reimbursement technology.
• Ability to stay abreast of Federal coding requirements and guidelines.
• Ability to submit clean claims and collect from private insurers, Medicaid and Medicare.