Works schedule is Monday through Friday, work hours may vary. Schedule to be discussed during interview.
Serve as the department's billing and coding specialist with a vast knowledge and application of all aspects of insurance claims filing for services provided at University Health Services (UHS). Performs other complex administrative duties and provides support relative to cashiering and payment processing.
Ensures accurate, compliant and timely submission of insurance claims to provide accurate and efficient reimbursement. Reviews patient encounters for proper use of procedure codes/modifiers and as diagnosis codes. Utilizes CPT, ICD-9 and HCPCS manuals to ensure accurate coding has been used to optimize reimbursement. Train providers and UHS staff on coding/billing guidelines. Reads and understands payor specific billing requirements as outlined in procedure manuals, payor newsletters and internal communication and incorporates and updates. Understands and complies with all applicable UHS and UT policies and procedures as well as all applicable state and federal laws. Processes payments from health insurance reimbursements for services provided at UHS as necessary. Correct rejected claims and perform appeals processing tasks as required from insurance companies in time efficient manner. Performs other duties as required, such as: data enters patient insurance information from various sources including electronic queue; assists patients with form completion to lift bars; establishes patient payment plan contracts; processes subscription apps; fields any inquiries for charges, payments, and/or refunds generated from UHS; performs IDT as necessary; process patient billing and Bursar transactions. Performs cashier duties in Cashier/Insurance Department as necessary. Accepts payments from patients and processes timely and accurately. Performs opening and closing procedures daily by preparing daily balance sheets, reconciling cashier batch summaries and securing all cash, checks, credit card receipts, and reconciliation tapes in locked depot bag. Maintains accurate cash drawer.
Other related functions as assigned.
High school graduation or GED. Certified coder-CPC or CCS. Three years of experience with clerical functions. Minimum of two years experience in insurance billing in paper and electronic environment and posting payments from Explanation of Benefits (outpatient family/general practice setting). Completion of subject matter related coursework and demonstrate knowledge can substitute for required years of experience. Knowledge of medical terminology, ICD-9, CPT-4, and HCPCS Coding. Excellent interpersonal and communication skills. Experience using Electronic Health Records, Billing Software, including Microsoft Word, Excel software Windows environment. Outstanding organizational skills. Attention to detail. Professional demeanor. Demonstrated ability to learn tasks quickly with minimal training and supervision. Demonstrated ability to successfully work with diverse community and provide services from a non-judgmental perspective. Equivalent combination of relevant education and experience may be substituted as appropriate.
Bachelors degree in business administration, finance, or other health-related field. Three or more years experience in insurance billing in paper and electronic environment and posting payments from Explanation of Benefits (outpatient family/general practice setting).
May work around standard office conditions May work around biohazards Repetitive use of a keyboard at a workstation Use of manual dexterity Exposure to fumes, chemicals, sprays, and commercial items found in standard office conditions, medical clinics, and in repairs and maintenance.