A/R Medicaid Specialist, Patient Accounting, UofL Health, Days, Full Time

Job description

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.