Patient Accounting Representative, PBO Follow Up, First Shift, Full Time
UC Health · Cincinnati, OH · 2 wk ago
HealthcareFull-time
Responsibilities
- Manage follow-up and resolution of professional billing accounts to ensure accurate and timely reimbursement.
- Conduct detailed research on claim denials, underpayments, and billing discrepancies using multiple systems, and take appropriate action to optimize collections.
- Maintain assigned work queues within established productivity and quality standards.
- Requires solid knowledge of the healthcare revenue cycle, physician/professional billing, and payer reimbursement methodologies.
Qualifications
- Minimum Required: High School Diploma or GED.
- Preferred: Associate's Degree.
- Licenses/Certifications: N/A.
- Minimum Required: 3 – 5 years of relevant experience in Revenue Cycle and/or Epic Revenue Cycle applications.
- Minimum 6 months experience in Medical claim follow up, 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.
- Preferred: 12 months experience in Medical claim follow up.
- Familiar with EPIC Resolute billing system, Claim Clearinghouse, and Payer Websites (I.e., Waystar, Availity).
- Understanding of Healthcare Revenue Cycle, from intake to final payment.
- Familiar with CMS-1500 claim form, required components, and basic coding requirements.
- Familiar with Basic Payer adjudication concepts and 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 its basic functions (I.e., EPIC, Athena, NextGen, Meditech).
- Understand common Billing / Insurance acronyms.