Note: The job is a remote job and is open to candidates in USA. UC Health is dedicated to advancing healing and reducing suffering, and they are seeking a Patient Accounting Representative. The role involves monitoring insurance claims, resolving billing issues, and ensuring timely reimbursement from insurance carriers.
Responsibilities
- Responsible for managing follow-up and resolution of professional billing accounts to ensure accurate and timely reimbursement
- Conducts detailed research on claim denials, underpayments, and billing discrepancies using multiple systems, and takes appropriate action to optimize collections
- Maintains assigned work queues within established productivity and quality standards
Skills
- High School Diploma or GED
- 3 – 5 years of relevant experience in Revenue Cycle and/or Epic Revenue Cycle applications
- 6 months experience in Medical claim follow up
- Or resolving credit balances
- Or performing electronic or manual cash posting
- Basic skill with MS Office applications, such as Excel, Print to PDF, Outlook and Fax from mail
- Understanding of Healthcare Revenue Cycle, from intake to final payment
- Familiar with CMS-1500 claim form, required components & understanding of basic coding requirements
- Understanding of Basic Payer adjudication concepts & Coordination of Benefits
- Ability to read and understand the Insurance Explanation of Benefits, including interpretation and application of the Remittance Advice or Claim Adjustment reason codes
- Ability to access and perform functions on various Payer claim portals. (I.e., Availity, Navinet, Anthem, Medicaid, Medicare)
- Familiar with the function of a claims Clearinghouse and the actions they perform (I.e., Zirmend/Waystar, ePremis, etc.)
- Prior use of a claim operating system and it's basic functions. (I.e., EPIC, Athena, NextGen, Meditech)
- Understand common Billing / Insurance acronyms
- Possess the ability to self-manage in a work from home environment using excellent communication and organizational skills
- Ability to manage daily schedule & accurately report time and attendance
- Ability to prioritize and coordinate workload with a high degree of proficiency and accuracy
- Must have excellent analytical and problem-solving skills; possessing good judgement skills and capable of making independent decisions in accord with policy and procedure
- Ability to reference and apply workflow or other guidance to daily work
- Able to effectively respond to constantly changing Payer rules with ability to work well under pressure in a flexible, diplomatic and expeditious manner
- Ability to work professionally and cooperatively with peers and other departments by phone or electronic media
- Must incorporate acceptable email and phone etiquette
- Must be accurate with attention to detail; documenting issue research and actions thoroughly in an abbreviated and comprehensive manner
- Willingness to learn new process and adjust common work practices when necessary
- Associate's Degree
- 12 months experience in Medical claim follow up
- Familiar with EPIC Resolute billing system, Claim Clearinghouse and Payer Websites (I.e., Waystar, Availity)
Company Overview