Green Card Commercial Specialist Jobs

Primary Location:

Work From Home - KY - UMC

Address:

Home Office
Remote, KY 40601

Shift:

First Shift (United States of America)

Job Description Summary:

UofL Health is a fully integrated regional academic health system with five hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehab Institute and 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.

Job Description:

Overview

This position requires thorough knowledge of the Uniformed Bill, timely filing limits set forth by various payers, and various payer websites for follow up. Performs all duties related to timely and efficient billing and follow-up. Thorough understanding of commercial payer eligibility, benefits, determining primary payer, and covered benefits. Understanding of billing policies for auto and worker’s compensation as well as incarcerated patient payers.

Responsibilities

• Monitor commercial and specialty payer accounts receivable inventory to ensure timely follow up and claims resolution.
• Adhere to quality and productivity standards assigned by management.
• Submit account for appeal on accounts where retroactive coverage has been obtained.
• Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.
• Follow up on unpaid commercial and third-party payer 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.
• Compliance with State and Federal Regulations.
• Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account.
• Ensure medical record requests are documented and submitted in a timely manner.
• Collaborate with denials team on difficult or reoccurring denials.
• Complete tasks by deadline.
• 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 the claim.
• Attend seminars as requested.
• Other duties as assigned.

Qualifications

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.