Senior Clinical Billing Specialist
University of Arkansas for Medical Sciences
Summary
The Senior Clinical Billing Specialist is an area expert, works under general direction, and is responsible for research, analysis and resolution of physician and hospital accounts. This position works directly with patients, providers, insurers, departments, and other staff in researching complex accounts, analyzing various information, and reviewing procedures and regulations to resolve issues.
Job description
The Senior Clinical Billing Specialist will review reports and monitor the status of accounts, recommend changes in operating procedures and policies, and practice best methods to complete billing activities. The position is knowledgeable of HIPAA regulations including patient confidentiality and always remains compliant. The position follows all UAMS policies and must demonstrate excellent verbal and written communication skills. Must be detail oriented and possess basic mathematical skills.
Key Responsibilities
- Investigate account balances and cause for non-payment, initiating claim adjustments, and re-submitting a clean claim to the payer or billing to patient
- Complete appeals within established time frame to avoid write offs
- Identify root cause of denials and create optimal solutions to prevent future denials; compose appeal letters for accounts denied and obtain necessary documentation
- Complete cash reconciliation
- Assist patients with billing, service and insurance questions; discuss accounts by phone and/or other electronic means to address concerns, verify insurance is properly billed and financial assistance posted
- Update systems with insurance or patient demographic corrections; verify new insurance information with payers; submit/resubmit claims
- Accept payments and post to the account systems
- Assist collection agencies to ensure uninterrupted self-pay collections
- Set up payment plans, post payments, and complete end of day processing
- Read, analyze and interpret contract documents
- Prepare records, reports, summaries, analyses, evaluations, and recommendations; develop statistical data
- Provide assistance to other department regarding insurance policies, collection processes, and billing
- Document encounters and action in appropriate systems
- Demonstrate integrity, innovative thinking, and make an active contribution to the success of the organization
- Comply with policy and procedures, confidentiality, and HIPAA policies and requirements
- Perform other duties as assigned
Requirements
- Bachelors in a related field plus one (1) year of experience in a healthcare revenue cycle related function or equivalent combination of education and experience
- Associate's degree in a related field plus three (3) years of experience in a healthcare revenue cycle related function
- High School diploma/GED plus five (5) years of experience in a healthcare revenue cycle related or bookkeeping function
- Must be familiar with Windows environment
- Ability to accurately read, analyze, and interpret contract documents for all payers to determine reimbursement
- Ability to analyze credit balance
- Preferred: Knowledge of EPIC billing system
Benefits
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Holiday Leave
- Vacation Leave
- Sick Leave
- Education Discounts
- Retirement Plan With Employer Matching
- Basic Life Insurance
- Career Training
- Educational Opportunities
- Merchant Discounts
- Prescription Delivery
Company overview
The University of Arkansas for Medical Sciences (UAMS) is Arkansas' only comprehensive academic health sciences university and the state's largest public employer. Founded in 1879 by eight physicians, UAMS has evolved into a statewide health system encompassing six colleges: Medicine, Pharmacy, Nursing, Health Professions, Public Health, and Graduate School. As a premier academic medical center, UAMS combines education, research, and clinical care through its UAMS Medical Center, which serves as Arkansas' only adult Level 1 trauma center and the state's sole provider of adult kidney, liver, and pancreas transplants. The institution operates with a $1.3 billion budget and generates over $100 million in annual research funding, maintaining internationally recognized programs in multiple myeloma, aging, and other specialized areas. UAMS supports over 3,000 students, 900 medical residents and fellows, and maintains affiliations with Arkansas Children's Hospital and the Central Arkansas Veterans Healthcare System. With eight regional campuses across Arkansas, UAMS provides extensive community outreach and telehealth services, ensuring healthcare access throughout the state while contributing approximately $3.92 billion annually to Arkansas' economy.