Responsible for assisting the revenue cycle team by performing one or more aspects of routine physician revenue cycle billing. Communicate and work with the University and UCM department, patients, payers and other external entities to obtain the necessary information to process claims, collect cash and reduce AR.
Ensures all eligible payments received are posted correctly and timely. This includes manual lockbox, ACH payments, and some transfer payments.
Manages electronic remittance edit work queues and accepts all electronic remittance files at the end of the day.
Works to reconcile cash variances.
Responsible for following up with payors and/or vendor websites to obtain documentation not received with payment.
Works Payment Investigation work queues to locate payments received but either not posted and/or posted incorrectly as identified by the insurance follow up team.
Responsible for making insurance follow-up phone calls to payors stating payment was sent, but payment cannot be located.
Perform patient and insurance inquiries for various revenue cycle activities; such as posting rejections, eligibility inquires for credit resolution, and other activities that contribute to AR/Account Resolution.
Perform revenue cycle activities to resolve the account balance, resolving complex Provider level adjustments (PBLs), credit balances, applying payments and adjustments to accounts.
Responsible for correctly processing refunds due to patients/insurance companies.
Work with payers to resolve missing remit file issues.
Communicate with revenue cycle experts regarding the necessary medical records and clinical and/or billing information needed from the department to resolve accounts and escalate issues when appropriate to revenue cycle experts and/or manager.
Assist in tasks related to projects and in the development, coordination and review of procedures.
Correspond with internal and external constituencies to obtain appropriate documentation and/or information in an effort to resolve the account.
Work Correspondence sent to UCPG related to incorrect payments or refund requests.
Other duties as assigned.
Ability to participate as a member of the staff in identifying priorities for the work unit and participate as a member of a work group or team.
Ability to interact and communicate with clarity, tact and courtesy with patrons, patients, staff, faculty, students and others.
Ability to work with supervision to identify and describe work task priorities.
Ability to recognize and resolve or refer problems and conflicts.
Ability to negotiate and manage interpersonal communication effectively.
Ability to understand medical terminology/documentation and basic documentation such as help screens and departmental handouts.
Ability to handle multiple concurrent tasks in a competent and professional manner in a fast paced atmosphere.
Ability to solve problems independently with limited direction from the supervisor.
Education, Experience or Certifications:
High School Diploma required.
Previous experience with physician billing required.
Previous experience using electronic medical records systems preferred.
Previous experience with diagnosis and CPT coding terminology required.
Previous experience working with third party payor rules, procedures and policies in physician billing required.
Medical terminology certification preferred.
Technical Knowledge or Skills:
PC experience and MS Office (Word and Excel) required.
Ability to communicate effectively in English, both orally and in writing.
Ability to use or learn to use a range of position related software applications.
These may include standard software packages as well as networked systems, email, the Web and other types of information.
Reference Contact info upon request
NOTE: When applying, all required documents MUST be uploaded under the Resume/CV section of the application
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