Senior Clinical Billing Specialist

University of Arkansas for Medical Sciences•Little Rock, AR

22d

About The Position

The Senior Clinical Billing Specialist is an area expert, works under general direction, and is responsible for research, analysis and resolution of physician and hospital accounts. This position works directly with patients, providers, insurers, departments, and other staff in researching complex accounts, analyzing various information, and reviewing procedures and regulations to resolve issues. The Senior Clinical Billing Specialist will review reports and monitor the status of accounts, recommend changes in operating procedures and policies, and organize best methods to complete billing activities. The position is knowledgeable of HIPAA regulations including patient confidentiality and always remains compliant. The position follows all UAMS policies and must demonstrate excellent verbal and written communication skills. Must be detail oriented and possess basic mathematical skills. Following on site training, minimum on campus schedule of one day each week, subject to change.

Requirements

Bachelor’s degree in a related field plus one (1) year of experience in a healthcare revenue cycle-related function or Associate’s degree in a related field plus three (3) years of experience in a healthcare revenue cycle-related function or High School diploma/GED plus five (5) years of experience in a healthcare revenue cycle-related or bookkeeping function required.
Must be familiar with Microsoft Windows and have the ability to accurately read, analyze, and interpret contract documents for all payers to determine reimbursement; analyze credit balance.
Must be detail oriented and possess basic mathematical skills.

Nice To Haves

Knowledge of the EPIC billing system preferred.

Responsibilities

Complete electronic and paper specialized billing while reviewing claims for accuracy on all accounts assigned.
Review and correct all claims that fail the billing system edits daily to ensure accurate and timely submission on accounts.
Document all actions that are taken on accounts in the system account notes to ensure all prior actions are noted.
Submit all corrected claims within the time frames assigned by management or document reasons for delays in EPIC.
Complete review of claims in Change Health and notes in EPIC to delete duplicate claims from Change Health.
When updating coverage, review accounts in EPIC and Change Health to make sure a claim is Demanded in EPIC to avoid duplicate billing.
Contact the payer or patient when additional information is required to bill the account.
Immediately report all new claim billing issues to management to coordinate with other departments and the electronic billing vendors to resolve barriers.
Answer questions and provide appropriate information to fellow team members regarding the billing process and requirements.
When unsure of a process, follow up with Management on questions/concerns.
Identify ways to improve billing processes and provide recommendations for new or revised procedures.
Collaborate with management on effective changes related to billing, achieving optimal financial outcomes, and compliance with regulations.
Stay abreast of the latest developments, advancements, and trends in the field of medical billing by attending in-services, reviewing online information, and reading information from payers and fiscal intermediaries.
Follow up with payers to ensure timely reimbursement.
Work well with other departments to ensure accounts are worked appropriately and timely.
Participate in compliance and regulatory programs.
Work effectively in a team environment, coordinating workflow with other team members and ensuring a productive and efficient environment.
Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, Joint Commission, EMTALA, and OSHA.
Demonstrates a high level of integrity and innovative thinking and actively contributes to the success of the organization.
Complete all required reports accurately and timely.
Demonstrate positive working relationships with co-workers, management team, and ancillary departments.
Assume responsibility for completing or assisting on special projects as assigned by the manager.
Adhere to UAMS and Centralized Business Office Department-related policies and procedures.
Adhere to UAMS confidentiality and HIPAA policies.
Participate in regular review and utilize feedback for continued quality improvement.
Maintain good working relationships with patients and families, visitors, physicians and other employees; fellows, hospital guest relations guidelines, and “Circle of Excellence” criteria.
Performs other duties as assigned.