AR Senior Specialist UofL Health Full-Time 1st Shift Days

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OverviewnPoint of contact for the billing scrubber system, responsible for running reports, creating edits and rules to improve the clean claim rate submission along with timely and efficient outstanding claim follow up.  Cross trained and assist in the billing for each claim type with the ability to efficiently submit medical insurance claims for all payers including Medicare and Medicaid. Proper knowledge of follow up workflows and best practices. This position requires thorough knowledge of the Uniformed Bill and various payer websites.  Role model for all Billing Specialist, flexible and coordinate billing work tasks.nResponsibilitiesnn Identify and recommend process efficiencies across the billing and follow up areas.n Effectively prioritize and assist in the billing and account follow up workload.n Monitor and resolve claims holding on discharged not final billed (DNFB) list.n Adhere to billing and follow up requirements and standards of compliance.n Ensure all claims are filed electronically except for some paper claims. n Log number of claims and dollars billed daily. Immediately report any delays to leadership.n Work specialized billing and follow up accounts (transplant, high dollar oncology, etc). n Ensure treatment authorization number is present, if applicable, in appropriate form locator field.n Thoroughly understand each of the condition, value, and occurrence codes for billing.n Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership. n Responsible for reviewing and understanding explanation of benefits/remittance advice to determine claim denials and paths to resolution. n Document all billing activity in a clear and concise manner into the AR system.n Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account.n Evaluate late charges to determine if late charge claim will generate additional reimbursement.n Ensure medical record requests are documented and submitted in a timely manner.n Collaborate with denials team on difficult or reoccurring denials.n Collaborate with AR Follow-up Specialist on difficult claims to identify barriers from the claim processing for payment.n Work with Education and Training Analyst to develop training aids for staff. n Complete tasks by deadline.n Identify and report all trends that may provide insight into payment challenges.n Proficient in billing scrubber systemn Work assigned accounts as directed while reaching daily productivity goals.n Attend seminars as requested.n Other duties as assigned.nnQualificationsnMINIMUM EDUCATION & EXPERIENCEnn High School Diploma or GEDn 2 years of Uniformed Billing experience is required.n Working knowledge of medical and insurance terms is desirable.nnKNOWLEDGE, SKILLS, & ABILITIESnn Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies. n Knowledge of general insurance requirements. n Experience working directly with EOBs and contractual adjustments. n General computer knowledge, working with electronic filing. n Ability to communicate verbally/in writing with professionalism. n Ability to meet productivity expectations. n

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