CUHCC’s mission is transforming care and education to advance health equity. The clinic is known for providing high quality care to diverse patients and is moving forward in improving timely access to care for patients. This position will focus on review, research and resolution of credit balances. This position will also work as a resource for patients, providers, interpreters and clinic staff within the billing department for medical, dental and mental health.
ESSENTIAL FUNCTIONS: Position overview and functions may change as position develops
1) Credit review/Refunds: (75%) a) Working knowledge of medical, dental and mental health care claim submission and reimbursement including understanding of Government program guidelines b) Understanding of coordination of benefits between primary and secondary payers c) Reviewing government and third party payer remittances d) Understanding of copays, coinsurance, deductibles and non-covered services e) Auditing account credit balances to determine that appropriate billing was done to insurance-filing corrected or voided claims as necessary for accurate billing f) Contacting insurance companies to discuss reimbursement issues and refund processes/guidelines g) Researching insurance credits to determine if a refund is needed and preparing recoup, void or refund to resolve credit balance per insurance guidelines h) Researching patient credits and entire account to determine if a refund is needed and preparing refund to resolve credit balance within compliance guidelines i) Review and respond to all insurance and patient refund requests j) Ability to recognize payment or adjustment errors and use corrective action appropriately k) Track refunds on payer websites and internal system l) Work with Accounts Payable to ensure accuracy and timely processing of refund checks including entry of refund check information on encounter within practice management system m) Identify and report trends in credits to Team Lead
2) Other job duties: (20%) a) This position will also be in the rotation at the clinic billing desk providing patients, providers and clinic staff with explanation of account balances, payment history and insurance coverage as related to medical, dental and mental health care departments b) This position will be in the billing team phone queue daily to assist patients with questions and accepting payments c) Work with team lead to identify areas for improvement d) Responsible on keeping manuals updated on position responsibilities and duties as well as refund, void and replacement claim procedures with each insurance e) Attend meetings with billing staff, Team Lead and Manager f) Cross-train with Cash Applications Specialist as backup
3) Other duties as assigned: (5%)
*CUHCC reserves the right to change or add duties to this position consistent with the job classification. **A negative TB test is required for this position.
The University of Minnesota, founded in the belief that all people are enriched by understanding, is dedicated to the advancement of learning and the search for truth; to the sharing of this knowledge through education for a diverse community; and to the application of this knowledge to benefit the people of the state, the nation, and the world.