"Sr Bill Clk/Pat Acct Rep Hlth"

Why Join the Revenue Cycle Department, Billing & Third Party Collections Team?

We are seeking a Senior Billing Clerk/Patient Account Representative to join our dedicated team of revenue cycle professionals for our Hospital Billing Team. We are in search of a highly motivated individual whose primary responsibilities will include accurate claim submissions, active collections, and resolving complex insurance inquiries and reimbursement issues. In this position, you will also play a vital role in monitoring and analyzing outstanding insurance receivables with responsibility for ensuring optimal reimbursement.

• Promote and maintain Revenue Cycle integration and claim standards for Hospital Billing.
• Accountable for outpatient commercial accounts within system work queues and clearinghouses.
• Review and resolve claims for accuracy based on payer standards.
• Complete all identified insurance required edits through electronic billing systems.
• Investigate payer responses and claim denials pursuing appropriate corrective action through write-offs, refunds, and/or transfers based on payer guidelines and contract agreements.
• Following compliance standards, investigate discrepancies and take appropriate corrective action for claim resolution/reimbursement.
• Contact appropriate third-party representatives, payer liaisons for status, information and/or claim issues escalation, ensuring professional and Michigan Medicine standards.
• Monitor and interpret reimbursement changes and trends. Reporting trends to Leadership.
• Respond and assist with complex billing, collecting, and/or operational inquiries from internal stakeholders, third parties and other customers.
• Assist in system testing for billing results.
• Meet with the Billing Manager/Supervisor regularly to effectively communicate and resolve billing/payer issues.
• Attend applicable training program initiatives which include but are not limited to MPAA sessions, third party seminars, and in-house training.
• Represent the unit with limited authority regarding general administrative and operational matters on an as-needed basis.
• 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.

Required Qualifications

• High school diploma or equivalent combination of education and experience.
• 2 or more years' experience within Revenue Cycle operations.
• Proficient usage of computers and software, including Microsoft 365 and Google products.
• Excellent verbal and written interpersonal skills.

Desired Qualifications

• Previous medical billing experience (Hospital, Professional, DME, etc.) preferred.
• Knowledge of University Health System policies, procedures and regulations.
• Experience within Billing systems; Epic, Waystar, Epremis.
• Understanding hospital reimbursement contracts.
• Ability to stay abreast of Federal coding requirements and guidelines.
• Ability to submit clean claims and collect from private insurers, Medicaid and Medicare.