<p>OBJECTIVE/OVERVIEW:<br /><br />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.<br /><br />ESSENTIAL FUNCTIONS:<br />Position overview and functions may change as position develops<br /><br />1) Credit review/Refunds: (75%)<br />a) Working knowledge of medical, dental and mental health care claim submission and reimbursement including understanding of Government program guidelines<br />b) Understanding of coordination of benefits between primary and secondary payers<br />c) Reviewing government and third party payer remittances<br />d) Understanding of copays, coinsurance, deductibles and non-covered services<br />e) Auditing account credit balances to determine that appropriate billing was done to insurance-filing corrected or voided claims as necessary for accurate billing<br />f) Contacting insurance companies to discuss reimbursement issues and refund processes/guidelines<br />g) Researching insurance credits to determine if a refund is needed and preparing recoup, void or refund to resolve credit balance per insurance guidelines<br />h) Researching patient credits and entire account to determine if a refund is needed and preparing refund to resolve credit balance within compliance guidelines<br />i) Review and respond to all insurance and patient refund requests<br />j) Ability to recognize payment or adjustment errors and use corrective action appropriately<br />k) Track refunds on payer websites and internal system<br />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<br />m) Identify and report trends in credits to Team Lead<br /><br />2) Other job duties: (20%)<br />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<br />b) This position will be in the billing team phone queue daily to assist patients with questions and accepting payments<br />c) Work with team lead to identify areas for improvement<br />d) Responsible on keeping manuals updated on position responsibilities and duties as well as refund, void and replacement claim procedures with each insurance<br />e) Attend meetings with billing staff, Team Lead and Manager<br />f) Cross-train with Cash Applications Specialist as backup<br /><br />3) Other duties as assigned: (5%)<br /><br /><br /><br />*CUHCC reserves the right to change or add duties to this position consistent with the job classification.<br />**A negative TB test is required for this position.</p><p>***This position is represented by a bargaining unit, AFSCME Clerical. Dues or fair share deductions will be made.***</p><p>Salary Range: $32,656 - $54,932.80</p><p> </p>
<p><strong><span style="background:white;"><span style="color:#333333;"><span style="font-family:arial,sans-serif;"><span style="font-size:9.0pt;">All required qualifications must be documented on application materials.</span></span></span></span></strong></p><p>Required Qualifications: <br />1. High school diploma/GED and four years of general accounts transaction experience. Training may be substituted for some of the years of experience.<br />2. Experience in a billing office<br />3. Experience with and demonstrated understanding of Explanation of Benefits required<br />4. Experience with and demonstrated knowledge of insurance verification, coordination of benefits, billing practices and insurance collections<br />5. Demonstrated/documented ability to multi-task, organize tasks and prioritize<br />6. Demonstrated/documented high-level oral and written communications skills to work with patients, staff, providers and insurance companies<br />7. Demonstrated/documented excellent customer service skills<br />8. Demonstrated/documented ability to work with patients and staff from diverse cultures, languages and backgrounds<br />9. Demonstrated/documented capacity to work on a team and make positive contributions to the team<br />10. Demonstrated/documented strong attention to detail<br />11. Demonstrated/documented knowledge of Microsoft Word and Excel in order to draft cover letters to patients and payers and review claims spreadsheet.<br />12. Demonstrated/documented knowledge of research, emails and calendar through Google Chrome Browser<br />13. Demonstrated/documented knowledge of Electronic Health Records & Electronic Medical Records (EHR/EMR)/Practice Manager/Software/System<br />14. Demonstrated/documented knowledge of MN-ITS through Minnesota Department of Human Services website to access other applications, verify eligibility, authorization requests, claims, replace or void a claim submitted, and check claim status<br />15. Demonstrated/documented knowledge of Washington Publishing Company (WPC) References Website to review Health Care Code Lists such as Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC)<br /><br />Preferred Qualifications:<br />1. Post-secondary education credits in business or healthcare<br />2. Fluency in one of CUHCC’s predominant patient languages (Spanish, Somali, Vietnamese, Lao, Hmong)<br />3. Knowledge of Federally Qualified Health Care Center (FQHC)</p><p> </p>
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.