HERC of the Carolinas

Our Revenue Cycle team is looking for a highly motivated Senior Billing Clerk/Patient Account Representative to join our Medicaid/Medicaid HMO Hospital Billing Team.

Responsible for accurate claim submission, resolve complex insurance inquiries and reimbursement issues; monitor and analyze outstanding insurance receivables with responsibility for ensuring optimal reimbursement.

• Your primary duties will include claim submissions, error corrections and insurance collections.
• You will initiate and process claims and other forms within prescribed guidelines; screening for accuracy completeness and conformity to required standards.
• You will investigate discrepancies and take appropriate corrective action when necessary ensuring compliance
• Move payments to accounts ensuring appropriate payment category, reimbursement level, contractual adjustment and liability transfer.
• Investigate claim denials and reimbursement issues, pursuing appropriate corrective actions including status of accounts, write-offs, refunds, transfers, and billing third party carriers within established guidelines.
• Monitor, interpret and advise management regarding payer system and reimbursement changes and trends.
• You will contact appropriate third party representatives for information and assistance with denied or incorrectly paid claims.
• Initiate and prepare standardized and ad hoc reports and correspondence based on respective area needs.
• Represent the unit with limited authority regarding general administrative and operational matters on an as need basis.
• Respond to complex billing and collections, financial, or operation inquiries third parties and other customers.  Home Infusion billers will periodically respond to patient phone calls and process credit card payments.
• Assist in development of unit policies and procedures including identification and testing of potential billing solutions.
• Once your training is complete, you will assist in training new team members.
• Attend applicable training program initiatives which include but are not limited to MPAA sessions, third party seminars, and in-house training.

• High school diploma or equivalent combination of education and experience
• Proficiency in use of computers and software, including Microsoft office products and email/calendar programs.
• Excellent verbal and written interpersonal skills.
• Ability to handle multiple items at a time
• Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, Federal, State and local requirements and JCAHO standards.
• Ability to respect and protect confidential information, work in a team environment, build trust in the working relationships with other staff and faculty, and work independently.
• Knowledge of medical insurance reimbursement policies and procedures.
• Demonstrated ability to work independently. 
• Demonstrated attention to details.  
• Demonstrated problem solving abilities are necessary.
• Demonstrated ability to handle multiple items simultaneously and produce high-quality work in a timely, accurate and efficient manner. 
• Direct experience related to hospital or professional billing, which may include recent completion of a medical billing program. 
  

• Knowledge of University Health System policies, procedures and regulations.
• Experience with University systems including MiChart/Epic, Outlook, as well as, NThrive, Epremis, CHAMPS, Webdenis and other payer websites.
• 2 or more years of billing experience
• Hospital billing experience within last 5 years.
• Deep understanding of ICD-10, CPT, HCPCS codes.
• Complete understanding of coordination of benefits
• Experience with documenting audits for code appropriateness.
• Solid understanding of hospital reimbursement technology.
•  Ability to stay abreast of Federal coding requirements and guidelines.
• Ability to submit clean claims and collect from private insurers, Medicaid and Medicare.

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

The University of Michigan is an equal employment opportunity employer.

About University of Michigan - Ann Arbor

A great university is made so by its faculty and staff, and Michigan is recognized as one of the best universities to work for in the country. The Michigan culture is known for engaging faculty and staff in all facets of the university to create a workplace that is vibrant and stimulating.For two consecutive years, the Chronicle of Higher Education has placed U-M in its "Great Colleges to Work For" survey. In particular, the university earns high marks for strong relations between faculty and administrators, a collaborative system of governance, strong pay and benefits, and a healthy work/life balance.

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