Associate Clinical Billing Specialist

University of Arkansas for Medical Sciences•Little Rock, AR

1d•Onsite

About The Position

This position is responsible for working assigned work queues while following related policies and procedures. Under general supervision, The Associate Clinical Billing Specialist will complete responsibilities in Cash Posting, Cash Control, Credit, and Data Entry/Scanning. The Associate Clinical Billing Specialist is responsible for timely and accurate posting of payments and adjustments to all patient accounts from multiple sources; will interpret the explanation of benefits (EOB) and balance transfer money to the secondary insurance or patient liability; scan and index all supporting documentation for manually posted payments; perform in depth research on payments and/or adjustments resulting in a credit balance or undistributed funds. This position is accountable for daily balancing and tracking of cash and adjustment posting and will balance summary activity in the patient accounting system, reconcile unapplied cash accounts, and post denial information; research missing payments with payers or clearinghouse to ensure all monies are claimed and posted; review credits on insurance and patient accounts to determine whether refunds are required. The Associate Clinical Billing specialist must be detail oriented and possess basic mathematical skills, above average communication skills, and exceptional attention to detail.

Requirements

High School diploma/GED plus 2 years of experience in a healthcare revenue cycle-related function or an equivalent combination of education and experience.
Must be familiar with Windows environment with the ability to accurately read, analyze, and interpret contract documents for all payers to determine reimbursement.
Analyze credit balance.

Nice To Haves

Bachelor’s degree OR High School diploma plus 4 years or equivalent combination of education and experience in a healthcare revenue cycle related function.

Responsibilities

Working assigned work queues while following related policies and procedures.
Completing responsibilities in Cash Posting, Cash Control, Credit, and Data Entry/Scanning.
Timely and accurate posting of payments and adjustments to all patient accounts from multiple sources.
Interpreting the explanation of benefits (EOB) and balancing transfer money to the secondary insurance or patient liability.
Scanning and indexing all supporting documentation for manually posted payments.
Performing in-depth research on payments and/or adjustments resulting in a credit balance or undistributed funds.
Daily balancing and tracking of cash and adjustment posting.
Balancing summary activity in the patient accounting system.
Reconciling unapplied cash accounts.
Posting denial information.
Researching missing payments with payers or clearinghouse to ensure all monies are claimed and posted.
Reviewing credits on insurance and patient accounts to determine whether refunds are required.
Identifying credit balance accounts through system reports and online work lists/work queues.
Receiving requests for refunds; researching accounts for potential refund and adjusting contractual allowances as needed.
Collecting documentation and completing analysis to determine whether a refund is appropriate; processing refunds timely.
Researching patient’s account history and applying patient overpayment to any outstanding patient balances(s).
Attaching supporting documentation upon receipt of processed refunds, preparing for distribution, and balancing to the patient accounting system and the accounts payable system.
Reviewing and resolving undistributed payments.
Following up on unpaid claims; verifying patient demographics, insurance information/eligibility, non-coding charge information, and updating accounts.
Maintaining working knowledge of payer groups and most current billing practices and regulations.
Running eligibility on patients, verifying insurance and requesting outside records.
Posting payments and adjustments to accounts in the patient accounting system.
Interpreting EOBs and transferring remaining patient and secondary insurance liability to appropriate accounts.
Translating payor denial codes to UAMS standard denial codes and entering on patient account.
Balancing all payments and transactions on a daily basis; researching unidentified cash and posting.
Reporting overpayments or refunds when identified during the payment posting process.
Resolving undistributed payments, researching payments, transferring funds and posting adjustments.
Distributing payments within the patient accounting system and researching payments received.
Investigating recoupments, interest payments and miscellaneous payments.
Claiming payments, completing Records of Deposit, and splitting funds to balance with other departments, reconciling bank reports, EFTs, insurance checks, personal payments, and Point of Service payments.
Preparing batches for manual payment posting and ensuring all money is accounted for and allocated.
Researching payments and interacting with insurance carriers and other agencies.
Working effectively in a team environment, coordinating workflow and supporting a productive and efficient environment.
Demonstrating integrity and critical thinking skills and actively contributing to the success of the organization.
Attending insurance carrier-provided training as needed.
Performing other duties and responsibilities as needed.