Sr Billing Clerk/Patient Account Representative Healthcare

Job Summary

Revenue Cycle Professional Billing (Medical Specialties) is seeking a Senior Billing Clerk/Patient Account Representative for BCBS/BCN Insurance Professional Receivables. Responsibilities include accurate claim submission, resolving complex insurance inquiries and reimbursement issues, monitoring and analyzing outstanding insurance receivables, recommending and implementing corrective actions, and resolving daily edits.

Responsibilities

• Status patient accounts for non-payment from BCBS/BCN, initiating appropriate follow-up action, responding to all levels of financial inquiries from patients, payers, hospital and department personnel.
• Monitor and analyze BCBS/BCN reimbursement levels.
• Recommend and implement corrective action for insufficient payment or inappropriate rejections.
• Analyze non-payment situations and recommend procedure changes which may resolve such negative trends.
• Resolve daily edits.
• Review claim forms for accuracy and completeness.
• Maintain unit productivity and quality assurance requirements.

Required Qualifications

• High school diploma or equivalent combination of education and experience.
• Ability to handle multiple tasks timely.
• Knowledge of Medical Insurance reimbursement policies and procedures.
• Ability to type 40-60 wpm with accuracy may be necessary.
• Proficiency in use of computers and software, including Microsoft Office product.
• Demonstrated excellent verbal and written interpersonal skills.
• Direct experience related to hospital or professional billing, which may include recent completion of a medical billing program.
• Demonstrated ability to handle multiple items simultaneously and produce high-quality work in a timely, accurate and efficient manner.
• Demonstrated experience 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 and faculty.
• Demonstrated ability to work independently.
• Demonstrated attention to details.
• Demonstrated problem solving abilities are necessary.

Desired Qualifications

• Knowledge of University of Michigan and UMHS policies, procedures and as well as regulatory requirements.
• Experience with UMHS systems including MiChart (epic), Outlook, Waystar, CHAMPS, Availity, as well as other payer websites.
• Professional or Facility billing experience within the last 5 years.
• 2-3 years office experience, including 1-2 years in a hospital or physician business office performing Commercial collection functions.
• Facility Billing experience could be considered.