Senior Billing Clerk/Patient Account Representative Health

About This Role

This role involves processing claims, resolving complex insurance inquiries, and monitoring outstanding insurance receivables for Commercial Insurance Professional Receivables in a healthcare setting. The primary goal is to ensure optimal reimbursement and accurate financial transactions.

Responsibilities

• Status patient accounts for nonpayment from Commercial Insurances, initiating appropriate follow-up action
• Respond to all levels of financial inquiries from patients, payers, hospital and department personnel
• Monitor and analyze Commercial reimbursement levels
• Recommend and implement corrective action for insufficient payment or inappropriate rejections
• Analyze nonpayment situations and recommend procedure changes which may resolve negative trends
• Resolve daily edits
• Review claim forms for accuracy and completeness
• Maintain unit productivity and quality assurance requirements

Requirements

• High school diploma or equivalent
• Ability to handle multiple tasks timely
• Knowledge of Medical Insurance reimbursement policies and procedures
• Proficiency in use of computers and software, including Microsoft Office products
• Demonstrated excellent verbal and written interpersonal skills
• 1-2 years office experience, including at minimum six months in a hospital or physician business office
• Demonstrated ability to handle multiple items simultaneously and produce high-quality work in a timely, accurate and efficient manner
• Demonstrated experience efficiently and professionally handling and protecting items confidential in nature
• Demonstrated ability work in a team environment, build trust in the working relationships with other staff and faculty
• Demonstrated ability to work independently
• Demonstrated attention to details
• Demonstrated problem solving abilities

Qualifications

• High school diploma or equivalent combination of education and experience
• 1-2 years office experience, including at minimum six months in a hospital or physician business office

Nice to Have

• Knowledge of University of Michigan and UMHS policies, procedures and regulatory requirements
• Experience with UMHS systems including MiChart, Outlook, Epremis, CHAMPS, Availity, as well as other payer websites
• Professional or Facility billing experience within the last 5 years
• 2-3 years office experience, including 1-2 years in a hospital or physician business office performing Commercial collection functions
• Facility Billing experience

Skills

* Required skills