Primarily responsible forreviewing and accurately billing unresolved outpatient medical claims for allUH hospitals. Also responsible foredits for specifically identified inpatient claims.
Monitors status of held claimsthat don't pass billing edits. These claims can have multiple issues such as LCD, CCI, missing charges,incorrect number of units on drug claims and missing CPT codes.
Partners with UH RevenueCycle Management Follow-up and Customer Servicestaff to analyze,resolve and review payer rejectedclaims.
Reviews and analyzes held claims for trends in order to notifymanagement and/or the department for resolution and correction.
Provides individual departments with any codingor billing updatesthat affect the charging and billing of claims.
Processes corrections for special projects to Medicare on Line.
Monitors that timely filing practices are utilized, by reviewingaging reports to assure that all claims are billed prior to timing.
Maintains knowledge of regulations and policies affecting thehospital medical billing industry.
Performs a detailed review of radiology and lab reports toassure correct ICD-10 coding for all UH hospitals pended claims.
Provides support for specialprojects.
Performs other duties as assigned.
*Thisrole may encounter Protected Health Information (PHI) as part of regularresponsibilities. UH employees mustabide by all requirements to safely and securely maintain PHI for our patients. Annual training, the UH Code of Conduct andUH policies and procedures are in place to address appropriate use of PHI inthe workplace.
High school diploma or equivalent required.
Associate's Degree in HealthAdministration or
related field preferred.
Credentials, Licensure or Certification (i.e. RN, RRT):
Coding Certificate preferred.
Three plus years of experience with hospital revenue accounting, billing,reimbursement and/or patient accounting required.
Basic understanding of generally accepted coding principles andmedical terminology required.
Must be detail-oriented and organized, with good analyticaland problem solving ability.
Notable client service, communication, presentation andrelationship building skills required.
Ability to function independently and as a team playerin a fast-paced environment required.
Must have strong written and verbal communication skills.
Special Skills & EquipmentKnowledge:
Demonstrated ability to use PCs, Microsoft Office suite,and general office equipment (i.e. Printers, copy machine, FAX machine, etc.)required.
Quadax or other hospitalclaim scrubber experience preferred.
Equal Opportunity Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity