Entry level position responsible for submitting and resolving medical claims of low to moderate complexity. Must remain current with governmental and third party billing, follow-up and appeal requirements for compliant billing and follow-up of both inpatient and outpatient claims for all wholly owned facilities and physician entities including internal and external policy requirements.
Responds to requests from management, staff, or physicians in a timely and appropriate manner.
Maintains patient and physician confidentiality and professionalism at all times.
Follows department policies and procedures to ensure accurate and timely claim resolution.
Effectively communicates utilizing telephone, form letters, e-mail, or internal correspondence to resolve patient inquiries and insurance issues.
Attends and participates in team meetings.
Utilizes worklists to review and analyze account balances in order to collect payment for medical services rendered.
Utilizes multiple system applications to review, update patient information as well as research and resolve outstanding AR balance.
Assists in the analysis of claims resolution and provides feedback to management for solutions and process improvements.
Performs follow up with insurance companies to ensure appropriate payment on claims, resolve denials, correct claims, and appeal claims.
Acts as a liaison with internal and external customers providing assistance in claims and receivables resolution in a high volume environment.
Contacts patients and guarantors to secure necessary billing information.
Documents accounts with clear and concise verbiage in accordance with departmental procedures.
Reviews and responds to correspondence and inquiries received.
Meets and exceeds team productivity and quality standards.
Performs other related duties as assigned.
*This role may encounter Protected Health Information (PHI) as part of regular responsibilities. UH employees must abide by all requirements to safely and securely maintain PHI for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
High School diploma or equivalent required.
Associate / Bachelor’s Degree preferred.
Medical Billing/Coding certification preferred.
Experience & Knowledge:
Minimum 1 year of experience in call center, patient registration, scheduling, office, banking, customer service or related medical field using computers required. An Associate’s or Bachelor’s degree in a related field, or a certification in Medical Billing/Coding from a recognized program, will be accepted in lieu of 1 year of work experience.
Must be detail-oriented and organized, with good analytical and problem solving ability.
Notable client service, communication, and relationship building skills required.
Ability to function independently and as a team player in a fast-paced environment required.
Must have strong written and verbal communication skills.
Special Skills & Equipment Knowledge:
Demonstrated ability to use PCs, Microsoft Office suite (including Word, Excel and Outlook), and general office equipment (i.e. printers, copy machine, FAX machine, etc.) required.
Experience with medical billing software preferred.
Equal Opportunity Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity