UofL Physicians

  • Medicaid Specialist

    Job Locations US-KY-Louisville
    Job ID
    2018-5188
    # of Openings
    4
    Category
    Billling/Collections
    Department
    UMC-UMC
  • Overview

    This position requires thorough knowledge of the Uniformed Bill, Medicaid and Managed Medicaid billing, and various payer websites for follow up.   Performs all duties related to timely and efficient billing and follow-up.  Thorough understanding of Medicaid eligibility, benefits, determining primary payer, and covered benefits.

    Responsibilities

    • Monitor and resolve claims holding on discharged not final billed (DNFB) list.
    • Assure all claims are filed electronically except for some paper claims.
    • Process claims identified from insurance discovery.
    • Submit account for appeal on accounts where retroactive coverage has been obtained.
    • Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.
    • Follow up on unpaid Medicaid and Managed Medicaid claims in a timely manner.
    • High dollar accounts will have consistent follow up until the account has been resolved.
    • Responsible for reviewing and understanding explanation of benefits/remittance advice.
    • Assure statements are generated for the patient responsibility amounts.
    • Utilize insurance websites to view and resolve claims.
    • Perform extensive account follow-up and provide analysis of problem accounts.
    • Document all follow up efforts in a clear and concise manner into the AR system.
    • Compliance with State and Federal Regulations.
    • Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account.
    • Assure medical record requests are documented and submitted in a timely manner.
    • Collaborate with denials team on difficult or reoccurring denials.
    • Complete tasks by deadline.
    • Identify and report all trends that may provide insight into payment challenges.
    • Phone contact with patient, physician office, attorney, etc for additional information to process the claim.
    • Work assigned accounts as directed while reaching daily productivity goals.
    • Attend seminars as requested.
    • Other duties as assigned.

    Qualifications

    • High School Diploma, or GED
    • 1 year of patient registration, billing or equivalent experience
    • Working knowledge of medical and insurance terms is desirable.

    KNOWLEDGE, SKILLS, & ABILITIES

    • Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
    • Knowledge of general insurance requirements.
    • Experience working directly with EOBs and contractual adjustments.
    • General computer knowledge, working with electronic filing.
    • Ability to communicate verbally/in writing with professionalism.
    • Ability to meet productivity expectations.

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed