Description

Are you interested in making a difference in patient care? Learn about our unique culture of respect, growth, innovation, the best patient care, and how we give back to the community.

At United Urology Group, our employees are at the heart of our mission and have incredible opportunities to impact our patients' lives with their urologic care.

• We foster a culture that thrives on compassion, teamwork, integrity, and diversity, all of which start with our staff!
• We deliver a cohesive approach to urologic care that provides patients with access to experienced specialists, a superb team of healthcare professionals, and the most advanced technology for patient treatments and therapies.
• We offer competitive salaries and a great work/life balance: enjoy your weekends!
• UUG offers outstanding benefits, including tuition reimbursement, health, dental, and vision insurance, corporate discounts, and much more!

United Urology Group is regarded as the leading urology network in the country. Our Affiliates include Chesapeake Urology, Arizona UrologyPhoenix & Scottsdale, Arizona UrologyTucson, Colorado Urology, and Tennessee Urology.

Position Summary:

The Electronic Data Interchange (EDI) Claims Specialist is responsible for the timely and accurate processing of health insurance claims with various insurance companies.

Primary Duties & Responsibilities:

• Responsible for the daily review of and mailing of paper claims.
• Review claims demographic edits for corrections.
  • Making appropriate updates within the practice management system.
  • Sending the corresponding encounter to the charge entry system.
• Obtain needed hospital documentation by communicating with providers and/or office staff.
• Research and resolve demographic issues within the practice management system to resolve claim issues.
• Responsible for resolving escalations from the vendor partner related to, but not limited to:
  • Clearinghouse rejections
  • Payer rejections
  • MD Coder charge entry
  • Medicaid portal billing
• Organizational and time management skills.
• Ability to multitask.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice.

Qualifications

Qualifications:

• Minimum High School Diploma or GED required.
• Three (3) to Five (5) years of Medical Billing insurance claim filing experience.
• Familiarity with medical billing software/terminology.
• Knowledge of ANSI 5010, HIPAA transaction standards, and e-health initiatives.
• Knowledge of UB04/1500, ERA, and claim edits.

Knowledge, Competencies & Skills:

• Proficient knowledge of Medical Terminology: ICD and CPT codes.
• Current knowledge of acceptable and appropriate clinical practice, quality assurance, and patient management and care.
• Demonstrated ability to work independently and as an effective healthcare team member.
• Proven organizational skills and ability to prioritize effectively.
• Accurate and efficient data entry skills.
• Excellent customer service skills.
• Strong written and verbal communication skills.
• Proficient computer software and database skills, especially with Word and Excel.
• Ability to multi-task, effectively problem-solve, and work in a fast-paced environment.
• Attention to detail, willingness to learn, and bring forth ideas.
• Ability to type a minimum of 40 words per minute.

Tech Requirements for the Job:

• High-speed, reliable internet connection to ensure uninterrupted communication and access to necessary systems and tools.
• Quiet and private work environment to maintain the confidentiality of patient information and minimize background noise during calls.
• Proficiency in using remote collaboration tools, such as video conferencing software, instant messaging platforms, and customer relationship management systems.
• Compliance with all security and privacy policies and protocols, including safeguarding patient information and maintaining HIPAA compliance.

Direct Reports:

• N/A

Travel:

• N/A

Physical Requirements for the Job:

• Regularly required to sit and stand for extended periods.
• Involves standing, sitting, walking, bending, stooping, and twisting.
• Requires full range of body motion, including manual and finger dexterity and eye-hand coordination.
• Occasionally lifts and carries items weighing up to 25 lbs.

Equal Opportunity Employer: United Urology Group and its affiliate practices are an equal opportunity employer. We do not discriminate based on race, color, religion, age, sex, national origin, disability, veteran status, or sexual orientation.

The successful candidate(s) for any UUG position will be subject to a pre-employment background check.

Actual compensation offered to candidates is based on work experience, education, and/or skill level.