A/R Medicaid Specialist, AR Operations, UofL Health, 1st Shift, Full-Time UofL Health UofL Health

Overview:

This position requires thorough knowledge of the Uniformed Bill, Medicaid and Managed Medicaid billing, secondary deductible/coinsurance billing, and payer resources for follow up. Performs all duties related to timely and efficient billing and follow-up. Thorough understanding of Medicaid eligibility, benefits, determining primary payer, and covered benefits.

Responsibilities:

  • Monitor and resolve claims holding on discharged not final billed (DNFB) list.
  • Ensure all claims are filed electronically except for some paper claims.
  • Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.
  • Follow up on unpaid Medicaid and Managed Medicaid claims in a timely manner.
  • High dollar accounts will have consistent follow up until the account has been resolved.
  • Responsible for reviewing and understanding explanation of benefits/remittance advice.
  • Ensure statements are generated for the patient responsibility amounts.
  • Utilize insurance websites to view and resolve claims.
  • Perform extensive account follow-up and provide analysis of problem accounts.
  • Document all follow up efforts in a clear and concise manner into the AR system.
  • Familiar with inpatient only procedure list and work with Revenue Cycle leadership to prevent denials
  • Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account
  • Ensure medical record requests are documented and submitted in a timely manner
  • Identify and report all trends that may provide insight into payment challenges.
  • Phone contact with patient, physician office, attorney, etc for additional information to process claims.
  • Work assigned accounts as directed while reaching daily productivity goals.
  • Complete tasks by deadline.
  • Attend seminars as requested.
  • Other duties as assigned.

Qualifications:


MINIMUM EDUCATION & EXPERIENCE

  • High School Diploma, or GED
  • 1 year of patient registration, billing or equivalent experience
  • Working knowledge of medical and insurance terms is desirable.

KNOWLEDGE, SKILLS, & ABILITIES
  • Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
  • Knowledge of general insurance requirements.
  • Experience working directly with EOBs and contractual adjustments.
  • General computer knowledge, working with electronic filing.
  • Ability to communicate verbally/in writing with professionalism.
  • Ability to meet productivity expectations.

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