Description

Job Summary:

To perform advanced patient financial service functions such as billing, follow up, receiving and reviewing correspondence, reviewing third-party and patient billing, and review and resolution of billing questions, register and schedule patients, ensure proper data integrity of patient demographics and billing. Ensures financial success for University of Mississippi Medical Center through diligent approach to work and attention to detail.

Knowledge, Skills & Abilities:

Advanced knowledge of medical claims processing. Ability to maintain confidentiality. Intellectual capacity to understand and analyze complex payer guidelines and proper billing regulations. Demonstrated analytical skills to discover root cause of errors and properly correct. Good verbal and written communication skills. Maintains professional standards. Effective organizational skills. Basic computer skills, including but not limited to proficiency in Microsoft Word and Excel, and basic data entry. Advanced knowledge of third-party insurance plans and government insurance plans.

KNOWLEDGE, SKILLS AND ABILITIES:

•  Advanced knowledge of medical terminology
•  Advanced knowledge of revenue cycle functions
•  Ability to pay attention to detail
•  Ability to maintain a professional appearance and attitude
•  Ability to read, write, type, and follow oral and written directions
•  Ability to work independently to effectively and efficiently perform assigned duties
•  Good interpersonal communication and organizational skills, and proven ability to work effectively with others

RESPONSIBILITIES:

Maintains strict confidentiality and adheres to all HIPAA guidelines and regulations.

Focuses daily on complying with policies, processes and department guidelines for assigned revenue cycle duties.

Prepares and submits clean claims to insurance companies either electronically or by paper in an accurate, timely and compliant manner.

Has a basic understanding of payer guidelines related to claim submission; is knowledgeable and proficient with payer websites and other useful resources pertaining to revenue cycle functions.

Works assigned reports, work-lists, and patient accounts.

Collaborates with management and co-workers in an open and positive manner.

Contributes to a positive working environment

Performs any other assigned duties since the duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time.

Environmental and Physical Demands:

Requires occasional exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold, occasional handling or working with potentially dangerous equipment, occasional working hours beyond regularly scheduled hours, occasional travelling to offsite locations, no activities subject to significant volume changes of a seasonal/clinical nature, occasional work produced is subject to precise measures of quantity and quality, occasional bending, occasional lifting/carrying up to 10 pounds, occasional lifting/carrying up to 25 pounds, occasional lifting/carrying up to 50 pounds, occasional lifting/carrying up to 75 pounds, occasional lifting/carrying up to100 pounds, no lifting/carrying 100 pounds or more, no climbing, no crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, frequent reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking. (Occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)

Requirements

Education & Experience:

High school diploma or equivalent required. Five (5) years of relevant revenue cycle experience. Knowledge of ICD-10/HCPCS/CPT coding.

Preferred:

Knowledge of medical terminology

Knowledge of appeals process.

CERTIFICATIONS, LICENSES OR REGISTRATION PREFERRED:

Certification as a Certified Revenue Cycle Representative (CRCR) through Healthcare Financial Management Associate (HFMA), or Certified Revenue Cycle Specialist (CRCS) through American Associate of Healthcare Administrative Management (AAHAM) preferred.