Patient Accounting Representative

• Understanding of Healthcare Revenue Cycle, from intake to final payment.
• Familiar with CMS-1500 claim form, required components & understanding of basic coding requirements
• Understanding of Basic Payer adjudication concepts & Coordination of Benefits
• Ability to read and understand the Insurance Explanation of Benefits, including interpretation and application of the Remittance Advice or Claim Adjustment reason codes.
• Ability to access and perform functions on various Payer claim portals. (I.e., Availity, Navinet, Anthem, Medicaid, Medicare)
• Familiar with the function of a claims Clearinghouse and the actions they perform (I.e., Zirmend/Waystar, ePremis, etc.)
• Prior use of a claim operating system and its basic functions.  (I.e., EPIC, Athena, NextGen, Meditech)
• Understand common Billing / Insurance acronyms

• Possess the ability to self-manage in a work from home environment using excellent communication and organizational skills.  Ability to manage daily schedule & accurately report time and attendance.
• Ability to prioritize and coordinate workload with a high degree of proficiency and accuracy.
• Must have excellent analytical and problem-solving skills, possessing good judgement skills and capable of making independent decisions in accord with policy and procedure. 
• Ability to reference and apply workflow or other guidance to daily work.
• Able to effectively respond to constantly changing Payer rules with ability to work well under pressure in a flexible, diplomatic, and expeditious manner.
• Ability to work professionally and cooperatively with peers and other departments by phone or electronic media.   Must incorporate acceptable email and phone etiquette.
• Must be accurate with attention to detail, documenting issue research and actions thoroughly in an abbreviated and comprehensive manner.
• Willingness to learn new process and adjust common work practices when necessary.  

•   Minimum

• 6 months experience in medical claim follow up.
  • Or resolving credit balances 
  • Or performing electronic or manual cash posting.
  • Basic skill with MS Office applications, such as Excel, Print to PDF, Outlook and Fax from mail.

•  Preferred:

• 12 months experience in medical claim follow up.
• Familiar with EPIC Resolute billing system, Claim Clearinghouse and Payer Websites (I.e., Waystar, Availity)

UC Health is an EEO employer