Insurance Receivable Specialist III

University of Utah; Salt Lake City (UT); On-site; USD 42,000 - 64,000; Full time

Job summary

The University of Utah Health seeks a billing professional to manage bundled billing, registration oversight, episode creation, and preparation of bundled packets, ensuring accurate reimbursement and contract compliance.

Responsibilities include follow-up on claims, denial resolution, HB/PB reconciliation, and serving as a patient advocate for balance resolutions, with a strong emphasis on accuracy and customer service.

Qualifications

• Four years of medical billing experience.
• Medical Billing terminology.
• Claims knowledge through AAHAM.
• Accounting reconciliation skills.

Responsibilities

• Performs insurance follow-up, denial resolution, and contract compliance ensuring timely and appropriate reimbursement, based on contract terms.
• Performs bundled billing functions including oversight of registration, charge routing, episode creation and preparing bundled packet.
• Performs reconciliation functions including HB/PB claims, Hospital / Physician payments, disbursements and episode balancing.
• Escalates claim's issues internally to other key departments (including Coding, Billing, Charging, Contracting, etc.).
• Resolves clinical and/or authorization denials through CARC analysis and appeals - including clinical documentation review, coordination with UR and/or attending physician.
• Acts as patient advocate in the resolution of balances.
• Prepares and monitors high dollar spreadsheets and/or payer escalations spreadsheets, as assigned.

Skills

Analytical thinking

Ownership

Attention to detail

Customer service

Problem solving

Job description

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

This position is responsible for bundled billing processes including episodic billing, contract compliance, reconciliation, and customer service. This position is not responsible for providing patient care.

Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.

Responsibilities

Essential Functions

• Performs insurance follow-up, denial resolution, and contract compliance ensuring timely and appropriate reimbursement, based on contract terms.
• Performs bundled billing functions including oversight of registration, charge routing, episode creation and preparing bundled packet.
• Performs reconciliation functions including HB/PB claims, Hospital / Physician payments, disbursements and episode balancing.
• Escalates claim's issues internally to other key departments (including Coding, Billing, Charging, Contracting, etc.).
• Resolves clinical and/or authorization denials through CARC analysis and appeals - including clinical documentation review, coordination with UR and/or attending physician.
• Acts as patient advocate in the resolution of balances.
• Prepares and monitors high dollar spreadsheets and/or payer escalations spreadsheets, as assigned.

Knowledge / Skills / Abilities

• The ability to express information in a clear and understandable manner.
• Ability to take a logical approach to resolutions.
• Ability to take ownership for the quality and timeliness of work and can achieve results with little oversight.
• Ability to resolve difficult or complicated challenges.
• Attends to details and pursues quality in accomplishing tasks.
• The ability to service and resolve customer requests with the customer in mind first and foremost.
• Demonstrated skills in analytical thinking.

Qualifications

Required

• Four years of medical billing experience.

Qualifications (Preferred)

Preferred

• Medical Billing terminology.
• Claims knowledge through AAHAM.
• Accounting reconciliation skills.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

• This is a sedentary position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Color Determination, Listening, Manual Dexterity, Near Vision, Sitting, Speaking, Standing

Multi-lingual Candidates Welcomed

To inquire about this posting, email: [e-mail]

EEO Statement

University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.

All qualified individuals are encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.

University of Utah Health Hospitals and Clinics, a part of The University of Utah, is an Aff…

To request a reasonable accommodation for a disability, please contact the University of Utah Health Hospitals and Clinics Human Resources office at 801-581-6500. If you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity (OEO). More information, including the Director/Title IX Coordinator's office address, electronic mail address, and telephone number can be located at: www.utah.edu/nondiscrimination/. Online reports may be submitted at oeo.utah.edu/

The University is a participating employer with Utah Retirement Systems(“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Hospitals and Clinics Human Resources at [phone] for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at [phone] or [phone] or Hospitals and Clinics Human Resources at [phone] if you have questions regarding the post-retirement rules.

This position may require the successful completion of a criminal background check and/or drug screen.

Requisition Number 86682
Reg/Temp Regular
Employment Type Full-Time
Shift Day
Work Schedule Monday-Friday, 8am-4:30pm
Clinical/Non-Clinical Status Non-Clinical
Location Name Business Services Building
Workplace Set Up Hybrid
City SALT LAKE CITY
State UT
Department COR ISC 10D SPECIALTY RECVABLE
Category Finance/Accounting
Workplace Set Up Hybrid