A/R Medicare Specialist - Remote Potential

We are Hiring at UofL Health for an AR Medicare Specialist!
Location: 250 E Liberty Street Louisville, KY 40202
Shift: Days (**Potential for remote work after completion of training and/or previous experience has been verified)
About Us
UofL Health is a fully integrated regional academic health system with seven hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehabilitation Institute and the Brown Cancer Center.
With more than 12,000 team members-physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals-UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.
Our Mission
As an academic health care system, we will transform the health of the communities we serve through compassionate, innovative, patient-centered care.
Job Summary
This position requires thorough knowledge of the Uniformed Bill, Medicare and Medicare Advantage billing, secondary deductible/coinsurance billing, and the DDE system for follow up. Performs all duties related to timely and efficient billing and follow-up. Thorough understanding of Medicare eligibility, benefits, determining primary payer, and covered benefits.

• Monitor and resolve claims holding on discharged not final billed (DNFB) list.
• Ensure all claims are filed electronically except for some paper claims.
• Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.
• Follow up on unpaid Medicare and Medicare Advantage claims in a timely manner.
• High dollar accounts will have consistent follow up until the account has been resolved.
• Responsible for reviewing and understanding explanation of benefits/remittance advice.
• Ensure statements are generated for the patient responsibility amounts.
• Utilize insurance websites to view and resolve claims.
• Perform extensive account follow-up and provide analysis of problem accounts.
• Document all follow up efforts in a clear and concise manner into the AR system.
• Submit shadow claims to Medicare for inpatient Medicare Advantage payers.
• Familiar with inpatient only procedure list and work with Revenue Cycle leadership to prevent denials
• Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account
• Adhere to Medicare Secondary Payer Questionnaire guidelines for coordination of payment/coverage with all other appropriate payers.
• Ensure medical record requests are documented and submitted in a timely manner
• Identify and report all trends that may provide insight into payment challenges.
• Phone contact with patient, physician office, attorney, etc for additional information to process claims.
• Work assigned accounts as directed while reaching daily productivity goals.
• Complete tasks by deadline.
• Attend seminars as requested.
• Other duties as assigned.

MINIMUM EDUCATION & EXPERIENCE

• High School Diploma, or GED
• 1 year of patient registration, billing or equivalent experience
• Working knowledge of medical and insurance terms is desirable.

KNOWLEDGE, SKILLS, & ABILITIES

• Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
• Knowledge of general insurance requirements.
• Experience working directly with EOBs and contractual adjustments.
• General computer knowledge, working with electronic filing.
• Ability to communicate verbally/in writing with professionalism.
• Ability to meet productivity expectations.

Benefits & Perks
• Competitive Pay & Benefits Options
• Paid Vacation, Sick days, and Holidays
• Free tuition to UofL for Part- and Full-time employees for Child/Spouse/Domestic Partner
• 401K with Employer Match
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