Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.
This position is full-time and works approximately 40 hours per week.
Department Name/Job Location:
This position is in the Department of Internal Medicine, Business Office. This position is for the Medical School Campus.
Position assists with many patient and billing related projects to identify and improve processes and maximize revenues and reimbursement. Position will help complete credentialing applications and will run, monitor and analyze selected AR reports, exception reports, provider reports, and prepare provider and management resource tools. Will develop and monitor front and back end edits to identify billing, credentialing, and controllable loss issues to minimize write offs and increase efficiencies. Will handle research billing and compliance related projects. Will assists with security requests for hospital-based systems and participate in project and management teams to review and improve processes. Handles other special patient billing related projects as assigned to support the department, division, office practice sites and the Heart Care Institute facilities.
PRIMARY DUTIES AND RESPONSIBILITIES:
Will assist with billing system changes and communicate system procedural changes to management. Will help educate staff on issues to promote efficient flow of billing for optimal reimbursement for the division. Will maintain updated procedures manual. Will serve as backup for daily operational issues.
Assists with HCI’s Group 4 UB claim forms issues by working with FPP I.S., PBS, department personnel and payers as needed to coordinate and solve issues, perform testing, and maintain current status of billing criteria to support technical and rehab billing processes.
Assists with the Medicare HCI and HCIA credentialing application processes for new and departed HCI providers and for the four entities of HCI and HCIA.
Requests creation of new or updated providers entries, locations, and dummy codes in the billing system to support division and HCI billing. Will participate in pricing reviews and request changes as appropriate.
Will assist with the submission of changes for HCI’s low pay reporting system timely with new and changed contractual rates by specific payer.
Works, monitors, analyzes selected AR aging reports and claim edits to identify billing, credentialing, and controllable loss issues in efforts to maximize efficiencies and improve reimbursement. Establishes, monitors, and works division specific TES/CM edits and supports staff with handling edits and evaluating encounters requiring forcing. Maintains division grid of user created edits and workfile assignment spreadsheet. Helps maintain current status of CDL related past pending and missing charges by linking appointments, reviewing CardioReport system, and being familiar with CDL’s unique processes. Creates manual visits as needed. Assists with compliance related projects and adjustments to accounts as needed.
Handles various aspects of the divisions research billing processes including review of research study invoices and handling of the research TES workfile to determine appropriate billing or write offs, working related patient inquiries and communications and maintenance of study information spreadsheets and contact listings.
Prepares and updates resource materials such as charge and Medicare allowable reference tools and provider listings as resources for clinical areas, providers, and/or management. Assists with provider related reporting needs and other reports as needed. Assists with audits and internal reviews of physician billed activities and pulls appropriate needed data. Will assist with running of reports to prepare hospital privilege data as requested.
Will assist with the security access requests for hospital-based systems (i.e. Clindesktop, Soarian, SIS, Compass, CardioReport, etc.) for all division personnel and provides training on new systems as needed.
Will assist as needed to create, update, and maintain current fee tickets for the division as assigned with CPT and ICD-10 coding and provider changes.
Will research patient complaints and issues and work with management team to resolve.
Will process the Heart Care Institute Healthlink administration fee analysis and payment report on a monthly basis.
Serves and participates on department and division level billing workgroup committees and teams and may assume leading roles as appropriate.
Works closely with the Specialist Billing Projects and the Cardiology/HCI billing manager and handles projects as assigned.
Equivalent of high school diploma with 4 to 5 years of experience in a medical office environment, or related field; knowledge of medical terminology;
Extensive telephone experience with demonstrated exceptional phone etiquette;
Experienced in a managed care setting; has experience using the IDX System; is familiar with WUSM services and programs;
Extensive knowledge with data entry/computer experience with an automated scheduling system
Understanding of system programs and applications.
Good knowledge of the IDX billing system and working knowledge of MS Excel and Word applications.
Knowledge of charge capture, billing and collections for physicians.
Good organizational and oral and verbal communication skills that require dealing with individuals at various levels of management and providers.
Ability to analyze accounts.
Working knowledge of medical terminology, ICD-10, and CPT coding.
Ability to effectively multi-task and meet deadlines.
AR revenue experience.
Great attention to detail.
Ability to remain focused and work closely with others.
Prior EPIC experience helpful but not required.
The hiring range for this position is $18.09 - $22.61 per hour.
Offers made for this position are contingent upon the successful completion of all required pre-employment screens, including a criminal background check, hair sample drug screen, and verification of required professional licenses, registrations, or certifications.
-Retirement Savings Plan -22 vacation days -8 Paid Holidays -Sick Time -Tuition benefits for employee, spouse and dependent children -Free Metro Link/ Bus pass -Free Life Insurance -Health, Dental, Vision -Health Savings Accounts (HSA) -Long Term Disability Insurance -Flex Spending Plan -Other Benefits
Med School HR website (medschoolhr.wustl.edu)
Internal Applicant Instruction:
This position is grade C08.
Please attach a copy of your most current signed performance evaluation (completed within the last 18 months) to your online account. If you have not received a performance evaluation, you may provide two current signed letters of recommendation (written within the last 18 months), preferably to include one letter from either a current or recent former supervisor. To attach these documents, go to: My Career Tools, Add Attachment, Attachment Type – Performance Reviews or Letters of Recommendation.
Washington University in St. Louis, a medium-sized, independent university, is dedicated to challenging its faculty and students alike to seek new knowledge and greater understanding of an ever-changing, multicultural world. The University offers more than 90 programs and almost 1,500 courses leading to bachelor's, master's and doctoral degrees in a broad spectrum of traditional and interdisciplin...ary fields, with additional opportunities for minor concentrations and individualized programs. The faculty is composed of scholars, scientists, artists and members of the learned professions. They serve society by teaching; by adding to the store of human art, creativity, understanding, and wisdom; and by providing direct services, such as health care.