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