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, 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.