OBJECTIVE/OVERVIEW: CUHCC’s mission is transforming care and education to advance health equity. The clinic is known for providing high quality care to diverse patients and is moving forward in improving timely access to care for patients. The Executive Accounts Specialist position ensures accurate Medical, Dental and Behavioral Health claims submission and reimbursements. The Specialist must be goal-oriented, revenue-driven, and self-motivated. The Executive Accounts Specialist must establish and maintain strong relationships with providers, clients, patients, and fellow staff. This position will also work as a resource for patients, providers, interpreters and clinic staff for medical, dental and behavioral health.
ESSENTIAL FUNCTIONS: 1. Billing/Accounts Receivable: (90%) a) Working knowledge of Medical, Dental, and Behavioral Health claims benefits, submission and reimbursement including understanding of government program guidelines b) Understanding of coordination of benefits between primary and secondary payers as well as submitting appeals c) Understanding of copays, co-insurance, deductibles, and non-covered services d) Utilize payer websites for claims status, eligibility & benefits, and appeals e) Timely follow up with insurance on unpaid or denied claims f) Effectively and professionally resolve claim issues with insurance companies by phone, website, email and mail; filing appeals where necessary g) Reading and interpreting insurance explanation of benefits (EOBs) h) Utilizing aging accounts receivable reports to follow up on all claims aged beyond 30 days i) Make necessary arrangements for medical record requests and/or completion of additional information requests from insurance companies j) Respond to all inquiries received from insurance companies, patients, and providers k) Resubmissions or secondary billing of claims, corrected claims, void and replacement claims, correcting and refiling to proper insurance l) Cross-training required for medical, dental, and mental health claims billing and collections m) Identify, report, and escalate trends n) Batching, dental coding, integrity review and submission of claims for medical, dental, and mental health o) Responsible for compliance and accuracy with billing guidelines p) Verification and follow up of provider documentation for completeness and accuracy for all claims prior to submission q) Identify issues with background processes included but not limited to Medicare G codes, MN Vaccine, sliding fee scale, and dental supply cost r) Responsible to keep updated with changes or processes and keep manuals updated on position responsibilities and duties s) Work with clinic intake staff on issues regarding authorizations, insurance setup, insurance verification, documentation t) Provide patients, providers, and clinic staff explanation of account balances, payment history, and insurance coverage as related to Medical, Dental, and Mental Health u) Answer phone in the billing phone queue v) Work on site at the clinic on a rotating basis to answer questions and help patients with billing issues and processing patient payments w) Regularly meet with Supervisors to discuss and resolve reimbursement issues, billing and AR obstacles or trends x) Attend and participate in weekly staff meetings and continuing educational sessions as requested y) Perform additional duties as requested by Supervisor or Management team
2. Other duties as assigned. (10%)
Salary Range: $32,656 - $54,932.80
CUHCC reserves the right to change or add duties to this position consistent with the job classification.
All required qualifications must be documented on application materials.
REQUIRED QUALIFICATIONS: 1. High school diploma/GED and four years of general accounts transaction experience. Training may be substituted for some of the years of experience. Two years of healthcare claims reimbursement experience which must include a minimum of: (A) Two years of customer service, (B) Two years of processing claims for a health-care entity, (C) One year in electronic claim adjudications, (D) Two years of computer experience in a professional working environment. 2. Demonstrated/documented proficiency in working with computerized billing software, Microsoft Word, Microsoft Excel and other programs. 3. Demonstrated/documented attention to detail and persistence in completing tasks. 4. Demonstrated/documented ability to multi-task, organize tasks and prioritize. 5. Demonstrated/documented high-level oral and written communications skills to work with patients, staff, providers, and insurance companies. 6. Demonstrated/documented excellent customer service skills. 7. Demonstrated/documented ability to work with patients and staff from diverse cultures, languages, and backgrounds. 8. Demonstrated/documented capacity to work on a team and make positive contributions to the team.
PREFERRED QUALIFICATIONS: 1. Aptitude and/or interest in working with Medical, Dental, and Behavioral Health patients, providers, clinic staff, and insurance companies on the phone in billing office setting and/or in person within a clinic setting. 2. Fluency in one of CUHCC’s predominant patient languages (Spanish, Somali, Vietnamese, Lao, Hmong) 3. Dentrix software experience. 4. Knowledge of Dental treatment plan and authorizations. 5. Experience working in a community clinic
A negative TB test is required for this position.
Internal Number: 333480
About University of Minnesota, Twin Cities
The University of Minnesota, founded in the belief that all people are enriched by understanding, is dedicated to the advancement of learning and the search for truth; to the sharing of this knowledge through education for a diverse community; and to the application of this knowledge to benefit the people of the state, the nation, and the world.