Billing Specialist I (Government Payers)

Henry Ford Health System - Troy, MI (26 days ago)3.9


This position is responsible for the Henry Ford Health System Insurance accounts receivable.

Identifies and determines in accordance with established policies and procedures – the accuracy and completeness of patient financial, insurance and demographic patient information to ensure compliant claims to Third party payers. Resolves problem accounts from payer denials and follows up on any claims that require a payer response. Responsible for the billing and collection of payments for all Henry Ford Health System hospitals, outpatient clinics and employed physicians.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Submit third party claim forms (i.e. UB04 or 1500) through the claims editing software. Understands the claim editing process and resolving the edits based on appropriate department procedures regarding claim submission.

2. Evaluate and investigate appropriate actions to be taken in order to resolve outstanding receivables, in accordance with department goals. Utilize various resources such as third party publications, procedure manuals and participating contractual agreements, etc.

3. Understand and resolves third party rejections using the payer system and the billing system. . Utilize various resources such as third party publications, procedure manuals and participating contractual agreements, etc.

4. Working knowledge of internal and external revenue cycle systems to manage receivables.

5. Ensure that all appropriate financial adjustments are posted accurately and in accordance with contracted payment rates, third party billing requirements, and HFHS policies and procedures.

6. Evaluate and validate correct payments received from third party payers.

7. Stay current with knowledge of payer and regulatory changes.

8. Meet established quality and productivity expectations

9. Identifies, resolves and reports potential issues to leadership

10. Supports the standards set forth in the HFHS Code of Conducts by adhering to legal and ethical standards.

11. Performs other related duties as assigned.

Minimum Pay Rate: $15.39/hr

This rate is the minimum pay for the position. Actual compensation will be based on education,years of experience, and other factors at the time of offer

EDUCATION/EXPERIENCE REQUIRED:
High school diploma or equivalent required.
One year experience in an office environment or healthcare-related field.
Prior experience in a healthcare revenue cycle position, preferred.
Knowledge of Medical terminology, preferred.
Knowledge of CPT/HCPCS revenue codes, preferred.
College course work in accounting, business or Health Care Administration, preferred.
Ability to communicate effectively with colleagues, supervisor, and manager
Ability to work independently
Strong organizational and time management skills required to effectively prioritize workflow to meet third party requirements.
Overview
Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health

care systems, is a national leader in clinical care, research and education. The system includes

the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health

insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory

network and many other health-related entities throughout southeast Michigan, providing a

full continuum of care. In 2015, Henry Ford provided $299 million in uncompensated care.

The health system also is a major economic driver in Michigan and employs more than 24,600

employees. Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient. The

health system is led by President and CEO Wright Lassiter III. To learn more, visit HenryFord.com.

Benefits
Whether it's offering a new medical option, helping you make healthier lifestyle choices or

making the employee enrollment selection experience easier, it's all about choice. Henry

Ford Health System has a new approach for its employee benefits program - My Choice

Rewards. My Choice Rewards is a program as diverse as the people it serves. There are

dozens of options for all of our employees including compensation, benefits, work/life balance

and learning - options that enhance your career and add value to your personal life. As an

employee you are provided access to Retirement Programs, an Employee Assistance Program

(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness

and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other

benefits and services.

Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.