Medical Insurance Clerk I - UMC Billing Office

Pay Grade/Pay Range: Minimum: $16.63 - Midpoint: $19.95 (Hourly N3)

Department/Organization: 208411 - UMC Business Office

Normal Work Schedule: Monday - Friday 8:00am to 5:00pm; occasional evening/weekend hours as needed

Job Summary: The Medical Insurance Clerk I processes insurance claims submitted for reimbursement. Communicates with insurance carriers and patients on coverage and payment requirements to facilitate timely reimbursement on outstanding claims. Completes daily review, posting, and reconciliation of various reimbursements from insurances carriers and/or patients. Scans EOB documents. Reviews and posts unapplied payments for proper allocation. Assists with the processing of refunds to patients and/or payors.

Additional Department Summary: Provides billing and clerical support for the University Medical Center Business Office. Responsible for operational and processing duties of all claims submitted for reimbursement for the College of Community Health Sciences (CCHS).

Reviews insurance claims, follows up with insurance carriers, and works with patients on coverage and payment requirements. Ensures timely reimbursement on outstanding claims. Partners with CCHS enterprise services (including Health Informatics, Medical Billing, Medical Records, and others) to meet short and long-term collection goals. Maintains strict confidentially of protected health information and follows HIPAA regulations at all times.

Required Minimum Qualifications: High school diploma or GED and some experience in a medical or insurance office; OR associate's degree or higher.

Skills and Knowledge: Detailed-oriented. Efficient and accurate computer and data entry skills. Ability to multi-task in a fast paced work environment. Excellent communication, public relations, customer service, and telephone etiquette skills. Willingness to learn, train/share relevant knowledge and consistently deliver patient-centered, high quality customer service. Desire to exemplify the core values and mission of the organization, always exercising utmost discretion, diplomacy, and tact in patient/staff interactions.

Preferred Qualifications: Associate's Degree, or 2 years of relevant training and/or experience in a medical insurance office with a focus on claims processing. Working knowledge of revenue cycle management, understanding of insurance payor protocols, CPT/ICD coding and/or medical terminology knowledge/experience preferred.

Background Investigation Statement: Prior to hiring, the final candidate(s) must successfully pass a pre-employment background investigation and information obtained from social media and other internet sources. A prior conviction reported as a result of the background investigation DOES NOT automatically disqualify a candidate from consideration for this position. A candidate with a prior conviction or negative behavioral red flags will receive an individualized review of the prior conviction or negative behavioral red flags before a hiring decision is made.