The University of Minnesota School of Dentistry is recruiting two Insurance Follow-Up Specialists for our Patient Accounting team.
The Insurance Follow-Up Specialists’s main focus is to obtain maximum and appropriate reimbursement for all claims from third party payers. The Insurance Follow-Up Specialist is responsible for preparing and submitting timely and accurate insurance claims to third party payers, assisting in the implementation of payer regulations, ensuring compliance to the regulatory requirements, and verifying payments and adjustments are appropriately applied to accounts based on government, contract or other regulations or agreements. The Insurance Follow-Up Specialist is responsible for appropriate follow up on all medical and dental accounts pending payments from all third party payers.
The Insurance Follow-Up Specialist is a member of the Patient Accounting team. We rely on each other to make the strongest team possible. Our team supports the mission of the School of Dentistry, which is to advance health through scientific discovery, innovative education, and the highest-quality care for all communities.
The School of Dentistry and the University of Minnesota provides equal access to and opportunity in its programs, facilities, and employment without regard to race, color, creed, religion, national origin, gender, age, marital status, disability, public assistance status, veteran status, sexual orientation, gender identity, or gender expression.
Performs regular and consistent follow up, denial management, correction and/or reprocessing claims as necessary to ensure timely resolution.
Utilizes all resources available, including electronic inquiries to verify eligibility and claim status.
Audits accounts by verifying that reimbursement amounts are appropriate.
Coordinates refunds, if appropriate.
Coordinates adjustments on patient accounts when necessary.
Submits claims appeals or resubmissions.
Competes accurate payment posting of third party payments on patient accounts.
Moves balances from insurance responsibility to patient responsibility when appropriate.
Reviews and resolves credit balances.
Other duties as assigned.
Account Management and Problem Solving (35%)
Responsible for submission of timely and accurate medical and dental claims to primary, secondary, and tertiary insurances for both electronic and paper submissions.
Ensures that medical and dental claims have the appropriate information on them for submission to insurance carriers, by reviewing errors or other prebilling insurance reports/worklists.
Contacts patients for additional information in order to have claims processed and paid in a timely manner as needed.
Analyzes and reviews claims to ensure that payer specific regulation and requirements are met.
Generates telephone calls to insurance carriers or accesses insurance carrier’s website to follow up on claims using worklists and reports generated for this purpose.
Evaluates and investigates appropriate action to be taken in order to reconcile patient accounts receivable.
Follows up on all unpaid claims through telephone contact or written correspondence to ensure that no account reaches no more than 180 days old from the date of service and is still unpaid by insurance.
Advises Supervisor of any billing errors, third party payer trends, denials or payment fluctuations to ensure proper handling and escalation of issue(s) when necessary.
Other duties as assigned.
Pay range: $20.23 - $24.34/hour
High School Diploma or GED and four years of general accounts and office experience. Training may be substituted for some of the years of experience.
Knowledge of personal computers, hardware and basic software programs including email, word processing and spreadsheets.
Advanced oral and written communication skills.
Experience with constructing messages that are clear and respectful in explaining and requesting work on an issue.
Accept and adapt to change as the medical/dental industry changes with new legislation, research, and technology.
Establish and maintain collaborative relationships.
Work effectively in a team environment.
Work independently with minimal supervision.
Respond calmly and effectively to sensitive and difficult situations.
Concentrate and pay close attention to details.
Utilize time management concepts and maximize time effectively.
Maintain flexibility to adapt to a variety of work load assignments.
Analyze accounts and compare to contracts, agreements and government regulations.
Make independent decisions that will not jeopardize the collectability or dollar amount received for services rendered.
Attend and participate in department and team staff meetings and other meetings as directed.
Participate in cross-training and training within the department, including mentoring others.
Knowledge of third party and governmental billing requirements and contracts.
Healthcare knowledge and medical terminology.
Ability to interpret policies and procedures, identify non-compliance and take appropriate action.
Internal Number: 338325
About University of Minnesota, Twin Cities
The University of Minnesota, founded in the belief that all people are enriched by understanding, is dedicated to the advancement of learning and the search for truth; to the sharing of this knowledge through education for a diverse community; and to the application of this knowledge to benefit the people of the state, the nation, and the world.