The Revenue Cycle Department, Billing & Third Party Collections work unit is looking for a Senior Billing Clerk/Patient Account Representative. Responsible for accurate claim submission, resolving complex insurance inquiries and reimbursement issues; reconciling billing and invoices, verification of balances, producing statements and invoices, maintaining client files and resolving patient billing inquiries and problems; monitoring and analyzing outstanding insurance receivables with responsibility for ensuring optimal reimbursement and resolution of credit balances. In addition, the senior level serves as a resource to others in the resolution of complex problems and issues; performs critical and complex billing-related functions requiring analysis, evaluation and an in-depth understanding of the accounts receivable system.
- Ensures that bills are submitted accurately with appropriate documentation, claim numbers, authorizations etc., and within timely filing limits.
- Reviews claim forms for accuracy and completeness within prescribed guidelines and conformity to required standards.
- Routinely reviews all patient accounts for nonpayment and initiates appropriate follow-up action to ensure timely collection.
- Responds to all levels of financial inquiries from patients and department personnel.
- Analyzes account credit balances and resolves via refund, account adjustments, etc.
- Recommends and implements corrective action for insufficient payment or inappropriate rejections.
- Analyzes nonpayment situations and recommends procedure changes which may resolve such negative trends.
- Focuses on reducing delinquent accounts and achieving maximum collections from all sources.
- Achieves productivity goals based on dollars collected, and aging period.
- Assists billing staff with resolution of complex billing issues and conducts problem-solving in a professional manner.
- Takes initiative in independently resolving a variety of complex issues and problems.
- Prepares special and periodic billing activity or other reports as assigned
- Adapts to change in a positive and constructive manner
- Creates, tracks and confirms prescriptions via software
- Obtains additional medical documentation as appropriate
- Obtains prior approvals as appropriate
- Incorporate LEAN principles into daily work
- Provides assistance in training staff in billing responsibilities including new hire staff
- Investigate discrepancies; take appropriate corrective action when necessary ensuring compliance
- High school diploma or equivalent
- 0-3 years of office experience, including 0-2 years in a hospital or physician business office performing insurance billing and collection functions
- Considerable knowledge of third party reimbursement policies and procedures
- Proficiency in use of computers and software, including Microsoft Office products
- Demonstrated excellent verbal and written interpersonal communication skills
- Demonstrated ability to handle multiple tasks simultaneously and produce high-quality work with attention to detail in a timely, accurate and efficient manner
- Demonstrated experience to work independently while efficiently and professionally handling and protecting items confidential in nature
- Demonstrated ability to work in a team environment, build trust in the working relationships with other staff
- Demonstrated problem solving abilities and enhanced analytical skills
Knowledge of University Health System policies, procedures and regulations. Experience with University systems including MiChart, Outlook, Webdenis, and other payer websites. Hospital billing experience within the last 5 years. Extensive knowledge of ICD-10, CPT, HCPCS codes. Must be able to efficiently document auditing for code appropriateness. Thorough understanding of Medicare reimbursement technology. Ability to keep abreast of Federal coding requirements and guidelines.
The employee will be able to perform the assigned duties and responsibilities with or without reasonable accommodations. This position requires knowledge and proficient use of computers and various computer applications. These duties require fine motor coordination/dexterity, the ability to grasp, vision with or without corrective aids adequate for fine motor tasks and computer skills. The position requires the employee to have the ability to sit for long periods of time.
Staff members may have exposure to all chemical inventory, inclusive of hazardous materials, housed at all work sites for Home Care Services, including but not limited to: the office, hospital, clinics, vehicles and warehouse. Chemical inventory reference materials are available to all staff in the form of hard copy and on-line Material Safety Data Sheets.
University of Michigan Health System conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
The University of Michigan Health System improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.