Senior Clinical Billing Specialist
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Job Description
Senior Clinical Billing Specialist responsible for billing and payment resolution in healthcare revenue cycle. Collaborating with patients and providers for account analysis and compliance with HIPAA regulations.
Responsibilities:
- Investigate account balances and cause for non-payment, initiating claim adjustments, and re-submitting a clean claim to the payer or billing to patient.
- Complete appeals within established time frame to avoid write offs.
- Identify root cause of denials and create optimal solutions to prevent future denials; compose appeal letters for accounts denied and obtained necessary documentation.
- Complete cash reconciliation.
- Assist patients with billing, service and insurance questions; discuss accounts by phone and/or other electronic means to address concerns, verify insurance is properly billed and financial assistance posted.
- Update systems with insurance or patient demographic corrections; verify new insurance information with payers; submit/resubmit claims.
- Accept payments and post to the account systems.
- Assist collection agencies to ensure uninterrupted self-pay collections.
- Set up payment plans, post payments, and complete end of day processing.
- Read, analyze and interpret contract documents.
- Prepare records, reports, summaries, analyses, evaluations, and recommendations; develop statistical data.
- Provide assistant to other department regarding insurance policies, collection processes, and billing
- Document encounters and action in appropriate systems.
- Demonstrate integrity, innovate thinking, and make an active contribution to the success of the organization.
- Comply with policy and procedures, confidentiality, and HIPAA policies and requirements.
- Perform other duties as assigned.
Requirements:
- Minimum Bachelor’s degree in a related field plus one (1) year of experience in a healthcare revenue cycle related function OR associate’s degree in a related field plus three (3) years of experience in a healthcare revenue cycle related function OR High School diploma/GED plus five (5) years of experience in a healthcare revenue cycle related or bookkeeping function.
- Must be familiar with Windows environment with the ability to accurately read, analyze, and interpret contract documents for all payers to determine reimbursement; analyze credit balance.
- Preferred Knowledge of EPIC billing system.
Benefits:
- Health: Medical, Dental and Vision plans available for qualifying staff and family
- Holiday, Vacation and Sick Leave
- Education discount for staff and dependents (undergraduate only)
- Retirement: Up to 10% matched contribution from UAMS
- Basic Life Insurance up to $50,000
- Career Training and Educational Opportunities
- Merchant Discounts
- Concierge prescription delivery on the main campus when using UAMS pharmacy
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