Senior Clinical Billing Specialist

University of Arkansas System•Little Rock, AR

17d

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 practice 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.

Requirements

High School diploma/GED plus five (5) years of experience in a healthcare revenue cycle related or bookkeeping function OR Associate’s degree in a related field, plus three (3) years of relevant work experience OR Bachelor’s degree in a related field plus one (1) year of relevant work 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

Knowledge of EPIC billing system

Responsibilities

Investigate account balances and cause for non-payment, initiating claim adjustments, and re- submitting a clean claim to the payer or billing to patient.
Complete appeals within the time frame established by management to avoid write off for untimely appeal processing.
Identify root causes of denial and create optimal solutions to prevent future denials. Write appeal letters for accounts denied, obtain necessary documentation, and attach same with letter of appeal.
Complete all cash reconciliation, including electronic remittances: insurance and agencies, reconciliation.
Assist patients with billing, service and insurance questions on the phone, via mail, or in person.
Update systems with insurance or patient demographic corrections; verify new insurance information with payer; submit/resubmit claims as indicated.
Accept patient payments over the phone and post payments to the Patient Accounting system according to department guidelines; generate receipts as appropriate.
Assist all collection agencies with requests when appropriate to ensure no interruption to the self-pay collection.
Discuss accounts with patients by phone, in person, in MyChart, email (or other electronic communication) or fax to respond to concerns and answer questions verifying all insurance has been billed properly and financial assistance posted.
Set payment plans, post payments manual and virtual in cash drawer, complete end-of-day processing following cash handling procedures.
Accurately read, analyze and interpret contract documents for all payers to determine reimbursement.
Maintain awareness of new and emerging trends in clinical, coding, or contract errors and report issues to management.
Stay current with latest developments, advancements and trends in the Revenue Cycle field.
Prepare clear, complete and concise records, reports, summaries, analysis, evaluations and recommendations. Develop statistical data for management to assess and determine issues that impact revenue recognition.
Assist departments within the hospital with questions about insurance policies, collection processes or other billing issues.
Document all encounters and actions taken in all appropriate UAMS systems including EPIC, Base Recover and/or DOMS to ensure all actions are understood by others.
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, Join Commission EMTALA and OSHA.
Demonstrate a high level of integrity and innovative thinking; actively contribute to the success of the organization.
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.
Comply with UAMS and CCBO policy and procedures, UAMS Confidentiality and HIPAA policies.
Perform other duties as assigned.