Underpayment Specialist Central Billing Office

2 weeks ago

Shelby, MI, United States McLaren Health Care Full time
Position Summary:

The Underpayment Specialist is responsible for performing audits of patient accounts to identify inaccurately under adjudicated accounts by the payer,and reconcile to the appropriate payer contract and corresponding explanation of benefits. Coordinates and reports audit outcomes as directed. Works closely with Revenue Cycle leadership and staff to identify process improvements that will allow payers to adjudicate claims per their associated contract. Underpayment Specialists will work with minimal direct supervision, reporting directly to the Patient Account Underpayment Manager of CBO Revenue Cycle.

Essential Functions and Responsibilities:

1. Under minimal direction, completes tasks accurately and timely. Seeks guidance and direction from leadership on tasks assigned.

2. Responds promptly, professionally and courteously to customers' requests.

3. Cooperates and communicates effectively with all McLaren Health Care team members

4. Contributes to continuous quality improvement efforts.

5. Organizes time and prioritizes effectively.

6. Practices cost effective measures.

7. Maintains confidentiality in all matters regarding patients, the hospital, the department and human resources.

Qualifications

Required:
• Associate degree required or equivalent combination of education and relevant experience may be acceptable
• Four years healthcare insurance billing experience; previous auditing experience preferred.
• Proven skills in Microsoft Office, specifically Excel and Word, Window based applications.
• Strong quantitative analytical and organization skills.
• Demonstrated exceptional oral and written communication.
• Team-oriented with strong interpersonal skills.
• Ability to understand contracted insurance terms and the various insurance payment methodologies/reimbursement terms.
• Working knowledge of CPT, HCPCS, and ICD-10
• Effectively communicate with the insurance carriers and their representative and customers.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

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