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Medical Billing & Collections Specialist I

Company: University of South Alabama
Location: Mobile
Posted on: November 17, 2019

Job Description:

Medical Billing & Collections Specialist ILocationBusiness Office Admin University Health Office Park (Airport/Azalea), ALJob TypeRegular Full-timeDepartmentUSA Health University HospitalJob NumberMultiple PositionsClosingContinuous

  • Description
  • Benefits
  • QuestionsAbout UsUSA Health helps people lead longer, better lives through its excellence in education, research and medical care. With more than 3,600 employees, USA's health network includes University Hospital, Children's & Women's Hospital, Mitchell Cancer Institute, Physicians Group, and the College of Medicine. Each year, our team of 180 physicians, 240 residents and fellows, 70 advanced practitioners and 800 nurses handle some 185,000 clinic visits and 350,000 outpatient procedures. USA Health delivers 2,800 babies a year, more than any other regional hospital, and treats patients through some 60,000 emergency room visits annually. In addition to advanced and innovative patient care offered at University hospitals and clinics, USA's medical education programs provide first-class training experiences for the next generation of physicians and scientists. USA Health delivers excellence in care while improving the quality of life for residents across the Gulf Coast.USA Health is managed by the USA HealthCare Management, LLC.Essential FunctionsAnswers telephone and provides information on patient statements/correspondence with the appropriate follow-up; assists walk-in customers with questions regarding billing; fields complaints and disputes to the proper personnel; works encounter interrupts daily; works e-mail daily; reviews and monitors in-house encounters; works incoming correspondences; completes encounters in work queues weekly; sets contact terms on encounters, which meet minimum payment requirements; follows up on delinquent formal payment plans; prepares encounters for audits and documents and charges with results of audit; researches self-pay encounters for insurance coverage and forwards information to proper area for encounter update; prepares encounters for recommendation of refund; verifies employment and checks probate court for property and estate claims; reviews discharged patients for correctness of patient and insurance information and necessary forms; recommends encounters for suit or placement with an outside collection agency or attorney; reviews Mobile County Record for court action involving patient encounters; submits encounters for estate filing; maintains a thorough and current knowledge of billing requirements and reimbursement methodology for all assigned coverages; maintains reports and lists as required by management; collects and reconciles encounters for assigned coverage; responds timely and accurately to written billing inquiries from patients and/or insurance companies; makes necessary demographic and insurance additions, deletions, and changes to the system guarantor/patient information; utilizes online systems for follow-up and reconciliation of encounters; works audit reports received from insurance companies; maintains encounter integrity by ensuring that insurance pro-ration, adjustments and transactions are accurate; reconciles encounters from insurance Explanation of Benefits; monitors insurance payments and allowances for proper reimbursement per contract; reconciles credit balances; checks work items and email daily and takes appropriate action; identifies solutions to work related problems and issues; requests medical records as needed and follows up on receipt of same; communicates and uses appropriate customer relations skills with physicians, patients, families and USA personnel in person and via telephone; communicates work-related problems and issues to supervisor or management staff; maintains accurate and complete records by documenting all follow-up activities with insurance company or patient clearly and concisely on the patient encounter; maintains proper filing of patient and insurance correspondence to include Explanation of Benefits and insurance denials; maintains contact file folder on all patients with established contract terms; adheres to hospital policies including confidentiality; participates on committees as assigned; participates in Performance Improvement activities as assigned; regular and prompt attendance; ability to work schedule as defined and overtime as required; related duties as required.Minimum RequirementsHigh school diploma or equivalent and four years hospital and/or medical business office experience. Hospital billing and claim follow-up experience relating to commercial, UHC & Medicare Advantage plans is highly preferred.Working Days and HoursMonday - Friday8:00 a.m. - 4:30 p.m.4 Vacancies

Keywords: University of South Alabama, Mobile , Medical Billing & Collections Specialist I, Healthcare , Mobile, Alabama

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