Responsible for assisting the revenue cycle team by performing all aspects of physician revenue cycle billing. Â Work with University and UCM departments, patients, payers other external entities to obtain the necessary information needed to process claims to collect cash and reduce AR. Â Perform special billing workflows (e.g. department pending, underpayments, transplants, etc.), review and resolve complex accounts and investigate root causes as well as provide revenue cycle trend analysis and identify solutions. Â Assume responsibility as the proactive resource and subject matter expert for revenue cycle activities.Â
Special Billing Workflows and Liaison Activities
Perform special and complex physician billing activities including collaborating with the departmental contacts to obtain appropriate clinical and/or billing information, resolve, WIN (Womenâ™s Infertility Network), high dollar, and Veterans Administration accounts.Â Â
Perform revenue cycle billing activities on other complex workflows as needed.
Maintain liaison activities with assigned clinical departments.Â
Communicate trends/patterns, issues, timely filing deadlines, and requests for documentation, etc.
Assist with monitoring the write off and adjustment process performed by the Accounts Receivable Representatives.Â Â
Research and resolve escalated customer service issues.Â Â
Monitor front and back-end revenue cycle edits.Â
Interpret medical policies and appeal requirements.Â
Perform campus revenue cycle activities and provide coverage when needed.Â
Perform revenue cycle billing activities for special projects regarding, unique accounts, payer issues, data analysis, and/or contract reviews, etc.
Facilitate training and ensure that revenue cycle staff understand policy and workflow processes.Â
Assist supervisor in developing and documenting policies and procedures.Â Â
Assist team members in resolving AR and monitor work queues.Â Â
Serve as a subject-matter expert on system upgrades with EPIC, including but not limited to conducting testing prior to go-live.
Physician Revenue Cycle Billing
Perform patient and insurance inquiries for various revenue cycle activities such as working rejections, no activity follow up accounts, registration-related functions, eligibility inquiries, and other activities that contribute to AR/account resolution; make insurance follow-up phone calls to payers.
Perform revenue cycle activities such as resolving claim edits, applying payments and adjustments to accounts.Â
Serves as a back-up for other areas.
Participate in annual and on-going mandatory compliance training and maintain knowledge of regular updates on billing compliance regulations.
Keep informed of changes in policy by reviewing regular Medicare bulletins and other relevant resources.
Be knowledgeable of and continually in compliance with all federal and state health care laws, regulations, and rules (including Medicare and Medicaid billing requirements that are applicable to the employee's job duties).
Other duties and functions as assigned.
Ability to work with minimal supervision.
Proven ability to effectively introduce procedures and processes to co-workers and other individuals.
Demonstrated ability to interact and communicate with clarity, tact, and courtesy with patrons, patients, staff faculty, students, and others.
Demonstrated ability to participate as a member of the staff in identifying priorities for the work unit and participate as a member of a work group or team.
Demonstrated ability to work with supervision to identify and describe work task priorities.
Demonstrated ability to communicate effectively in English, both orally and in writing.
Demonstrated ability to recognize and resolve or refer problems and conflicts.
Demonstrated ability to negotiate and manage interpersonal communication effectively.
Demonstrated ability to use or learn to use a range of position related software applications.Â These may include standard software packages as well as networked systems, email, the Web, and other types of information structures.
Demonstrated ability to read and understand basic documentation such as Help screens and departmental handouts.
Confidentiality/discretion must be maintained at all times.
Ability to handle multiple concurrent tasks in a competent and professional manner in a fast paced atmosphere.
Ability to understand medical terminology/documentation.
Ability to solve problems independently with limited direction from the supervisor.
Education, Experience, or Certifications:
High School Diploma or GED required.
Minimum three years previous physician revenue cycle experience required.
Previous experience with physician revenue cycle required.
Previous experience using electronic medical records (EMR) systems required.
Previous or current experience working with EPIC required.
Previous experience working all Government Payors including but not limited to Medicare, Medicare Advantage Plans, Medicaid and Medicaid MCOâ™s required.
Previous experience with diagnosis and CPT coding terminology required.
Previous experience and advanced knowledge working with third party payer rules, procedures and policies in physician billing required.
Experience and skill working with MS Office (Word and Excel) required.
Experience and skill working with Power Point preferred.
Medical terminology certification preferred.
Certified Professional Coding certification preferred.
Working Conditions and Physical Requirements:
$21.97 - $32.16 hourly
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