Insurance Receivable Specialist II

University of Utah Health • Salt Lake City, UT

1d • Onsite

About The Position

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA This position is responsible for insurance receivables collections, denials resolution and internal/external customer service. Account portfolio may include accounts less complex in nature. This position is not responsible for providing patient care. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Requirements

• Three years of medical billing experience, or equivalency.

Nice To Haves

• Understanding of Medical billing terminology or equivalent.
• Demonstrated claims knowledge through AAHAM certification, or equivalency.
• One year of coding experience using ICD-10.

Responsibilities

• Performs insurance follow-up and denial resolution on outstanding claims.
• Performs contract compliance on outstanding claims, ensuring timely and appropriate reimbursement based on contract terms.
• Performs payment compliance reviews and resolutions based on projects focused by payer, service, entity, trend, etc., as assigned by unit leader.
• Ensures appropriateness of patient responsibility, as assigned by payer/contract/benefit.
• Resolves clinical and/or authorization denials through CARC analysis and appeals - including clinical documentation review and coordination with UR and/or attending physician.
• Acts as patient advocate in the resolution of balances.
• Prepares and monitors high dollar spreadsheets and/or payer escalations spreadsheets, as assigned.
• Escalates claim issues internally to other key departments including Coding, Billing, Charging, Contracting, etc.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees