Responsible for all aspects of insurance verification, billing, and claims resolution. Responsible for coordinating insurance claim filings including submission, tracking, payment posting, allocation, and appeal of denials. Submission and tracking of pre-determinations and prior authorizations. Establish and maintain contact with third party pay (insurance) providers to be aware of process, qualifications, and coverage changes. Counsel patients, students, faculty, and staff regarding third party coverage. 50% Verify third party payee coverage, enter information into patient billing software. Follow-up with unpaid claims and forward complex claims to the Supervisor of Revenue Cycle. Respond to insurance requests for additional information. Post and allocate payments to patient accounts. Run and analyze EDI (electronic billing) reports and make determination of accounts that need to be converted. Contact third party payers regarding changes in coverage and billing processes. Counsel patients, faculty, students, and staff regarding third party coverage. Work insurance accounts receivable on an ongoing basis.
DUTIESANDRESPONSIBILITIES: Customer service including participation in telephone phone tree and rotation to off-site locations approximately every 6-8 weeks. Counsel patients and students regarding third party payments and investigate non-payments in order to provide explanations to patients and students.
Prepare, submit and follow-up on pre-determinations and prior authorizations
Perform other miscellaneous duties related to collections, including following up on claims filed and providing information to administration. Other duties as assigned.
REQUIRED: High School Diploma or GED, plus 2 years experience in a healthcare customer service setting. Annual TB test and up-to-date immunizations.
The successful candidate should possess and understanding and ability to provide outstanding customer service. Computer experience in a data base and previous use of Microsoft Office programs. Ability to communicate in a busy work environment with many customers.
Some college. Dental terminology highly desirable.
Working Conditions/Physical Demands:
This position requires extensive time in a stationary position, computer, and phone use. Must be able to review information on a computer monitor as well as Explanation of Benefit paperwork. Must be able to communicate on the phone in a busy office environment. Regular attendance is required.
Founded in 1820, Indiana University is the state’s public university system, comprised of two core campuses—IU-Bloomington and IUPUI—and six regional campuses located throughout the state. Combined, the total student population is more than 114,000 undergraduate, graduate and professional school students. IU is one of the largest employers in the state, with over 20,000 faculty and staff. Indiana University is an equal employment and affirmative action employer and a provider of ADA services. Diversity and inclusion remains a core commitment to IU’s mission to cultivate an educational environment that supports equal access, participation and representation on all of its campuses and that provides educational and career opportunities for all.