University of Rochester Insurance Collection Spec in Rochester, New York
Full Time 40 hours Grade 008 Radiology Billing Office
8:30 AM-5 PM
Under minimal direction perform insurance collections functions for the Billing Office. Receives direction from Collection Leads and Billing Manager.
- Reviews denied claims via Flowcast ETM and takes appropriate actions to correct. Researches why claim was denied, makes corrections and submits updated claim or appeal. Utilizes on line payer websites to obtain denial and eligibility information. Confers with Coding Staff and Charge Entry staff as needed to research denial. Is cognizant of service location to ensure accurate reporting of Place of Service and to professional vs global billing site billing. Utilizes organizational billing systems such as HBOC, McKesson Paragon, eRecord, Imagecast and Flowcast to complete review.
- Via Flowcast ETM, Reviews status of claims that have not been adjudicated by the insurance company to determine reason for lack of activity. Utilizes on line payer websites to obtain denial and eligibility information. Makes necessary corrections and resubmits claim.
- Reviews and resolves all correspondence and mail received in the office for their portion of the work assignment. This can include communications from insurance companies regarding denials, requests for medical records, appeal responses, audits, and other requests. Can also include correspondence from patients regarding their billings. Responds timely and accurately to all mail received. May include responding via telephone, fax or email.
- Completes A/R aging reports as assigned by Lead. Reviews aged accounts and completes actions necessary to resolve. Recommends account write-off when warranted. Maintains lists of accounts that have been placed with provider representatives for assistance and updates Lead as to their status. Remains cognizant of billing trends and communicates any identified problems to Lead and Manager.
- Completes Flowcast charge entry as needed. Accurately enters charges into Flowcast to create claims for billing. Reviews charge codes, modifiers and diagnosis for accuracy during entry and confers with Coding Team or Lead on any questions. Balances charge entry batches. Completes claim entry into payer website applications such as Epaces or Connex.
- Other duties as assigned.
Associates Degree in Business Administration and 2 years hospital patient accounting or consumer collations experience or certification obtained from a nationally accredited billing program (i.e., Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical Reimbursement Specialist CMRS); or an equivalent combination of education and experience.
Preferred qualifications include a familiarity with Medical Terminology, CPT-4 and ICD-10 codes. Candidate should possess strong analytical and mathematical capabilities, data entry skills and an ability to accurately complete a high volume of entry on a daily basis. Ability to learn and retain knowledge of multiple billing systems which will be utilized daily and maintain a detailed knowledge of insurance regulations and billing procedures.
EOE Minorities/Females/Protected Veterans/Disabled
Job Title: Insurance Collection Spec
Location: Medical Faculty Group
Job ID: 201319
Full/Part Time: Full-Time