Program/Unit Description Overview: Under the supervision of Billing Manager, this position performs, claim batching and electronic review of medical/Behavior Health (BH) charting. Submitting HCFA/UB claims; review and problem-solve returned, disputed, or rejected claims from Medicaid, Medicare and other third-party payers; and serve as a resource to patients as well as other health care professionals regarding insurance coverage and medical /BH billing.
Duties/Responsibilities Essential Functions:
Knowledge of FQHC billing for Medical and Behavioral Health Claims
Knowledge of CPT/ICD Guide to Medical and Behavioral Health Procedures/Diagnosis Codes
Review and correct both system and payer generated edits.
Manage coordination of benefits between primary and secondary payers.
Update and/or correct third-party payer information attached to claims.
Utilize payer eligibility systems to determine coverage.
Contact third-party payers to resolve outstanding claims and expedite payment.
Identify and report trends in claim errors.
Identify opportunities for improvement on claim reimbursement.
Prepare appeals, resubmit claims, and perform all actions necessary to obtain payment.
Patient Service responsibilities including explanation of account balances, payment history, and insurance coverage as related to patient responsibility balances in Medical, Dental and Mental Health Departments. This may include face to face interactions as well as phones.
Pay Rage: $16.18 - $27.21 per hour
Any offer of employment is contingent upon the successful completion of a background check. Our presumption is that prospective employees are eligible to work here. Criminal convictions do not automatically disqualify finalists from employment. Documents that MUST be attached by the applicant (Required Documents) Resume/Curriculum Vitae Documents that CAN be attached by the applicant (Optional Documents) Cover Letter/Letter of Intent
All required qualifications must be documented on application materials.
High school diploma/GED and four years of general accounts transaction experience. Training may be substituted for some of the years of experience.
Experience must include two years of healthcare claims reimbursement experience which must include a minimum of:
Two years of customer service
Two years of processing claims for a health-care entity
One year in electronic claim adjudications
Two years of computer experience in a professional working environment.
Electronic Health Record experience.
EHS software experience.
One year experience in FQHC/Community Health Care setting.
Knowledge of ARMHS and Case Management programs.
At least two years of post-secondary education involving business curriculum.
Experience in multicultural medical or social services setting.
Critical thinking skills and detail oriented.
Internal Number: 332039
About University of Minnesota, Twin Cities
The University of Minnesota, founded in the belief that all people are enriched by understanding, is dedicated to the advancement of learning and the search for truth; to the sharing of this knowledge through education for a diverse community; and to the application of this knowledge to benefit the people of the state, the nation, and the world.