This position will be either five days a week at 40 hours, or it is possible for this position to be 32-34 hours per week for four days a week. That decision and discussion can be decided upon offer of position.
This position prepares, submits and follows up on electronic and paper dental and medical insurance claims. They ensure claims are accurate and in compliance with standards before they are submitted to third-party carriers and that all required treatment documentation is attached. They follow-up on outstanding insurance A/R in a timely manner and responds to issues identified on EOB’s. This role will be responsible for allocating insurance payments and adjustments within established accounting and Edge protocols
This position provides back up for the clinic financial coordinator position and assists with registration and scheduling of new exam patients.
40% Insurance Claim Submission
Submit and monitor predetermination of patient coverage and daily, batch electronic dental and medical claims.
Prepare claims for submission using data quality assurance techniques, and; attach treatment data and imaging, when required, per individual insurance requirements.
Follow-up on submitted claims to verify payer receipt.
Resolve claim submission problems.
Document conversations and steps taken to resolve issues in Edge.
Resolve and/or communicate claims submission problems to supervisor.
30%: Insurance submissions and follow up
Insurance A/R Follow-up:
Investigate pending insurance A/R using reports from generated from Edge.
Document all follow-up.
Resolve issues preventing processing at the payers.
Submit Claims to Insurance Companies:
Submit claims to payers that require special handling/procedures, scan payment explanations and other patient data. Handles incoming and outgoing claim inquiries via telephone, in-person and written correspondence.
15% Claims, audits, documentation
Prepare and process secondary claims via MN E-Connect software and retrieve appropriate explanation of benefits and remittance advice data.
Documents the patient account on the insurance text screen with pertinent information such as referral information, payment explanations and pre-determination information not already documented elsewhere in Edge.
Reviews accounts needing insurance refunds including documentation in various areas of the Edge system.
Processes insurance refunds according to established procedures.
15% Miscellaneous Insurance, team coverage and related duties as assigned
Work Flow Documentation:
Keeps data and files related to problem corrections, and procedures as applied to unique claims submission, payment allocation and AR follow-up requirements.
Calling and Registering of new patients
Assist or cover for patient payment contract drafting and collecting
Assist with collection of payments or insurance questions of current and potential payments
Other duties as assigned
*Please note that the University's financial systems require training and demonstrated proficiency before access will be granted to those systems.*
Hourly Salary Range: $16.18 to $27.21 USD/hour
The University of Minnesota offers a comprehensive benefits package including:
Competitive wages, paid holidays, vacation and sick leave
Low cost medical, dental, and pharmacy plans
Health care and dependent daycare flexible spending accounts
Excellent retirement plans with employer match
Disability and employer paid life insurance
Wellbeing program with reduced insurance premiums
Tuition reimbursement opportunities covering 75%-100% of eligible tuition
Student loan forgiveness opportunity
Opportunities for growth and promotion
Employee Assistance Program
For more information regarding benefits: https://humanresources.umn.edu/sites/humanresources.umn.edu/files/2018_tcd-cslr-75100-ben-0105-7.pdf
All required qualifications must be documented on application materials.
High school diploma/GED and four years of general accounts transaction experience (training may be substituted for some of the years of experience); of the required four years, candidate must have at least two years of general account transaction with insurance claim submission and accounts receivable management in a medical or dental setting including insurance claim management.
Experience making financial adjustments/charges/corrections on patient accounts.
Experience with computers, bookkeeping, (accounts receivable) cash handling and /or fee collections.
Demonstrated ability to organize work under pressure
Demonstrated advanced oral communication skills
Demonstrated advanced written communication skills
Must be able to handle difficult/challenging situations
Proven ability to organize and analyze information from variety of resources.
Proven strong time management and multitasking skills, including organization and prioritization skills in meeting deadlines.
Works well independently and as part of a team; good team player and excels in team work and team situations
PC skills for data entry and retrieval in server system and experience utilizing MS word and Excel programs
Highly Preferred Qualification:
Experience with and knowledge of managed care medical assistance and non-managed care medical assistance, PPO, commercial managed care, government and fee-for-service medical and dental plans claim submission requirements.
Experience screening claims for accuracy, including appropriate use of diagnosis codes, procedure codes, and provider numbers.
Experience coordinating claims submission between multiple insurance companies.
Experience auditing accounts and experience making financial adjustments/charges/corrections to accounts.
Experience reading and interpreting dental and/or medical charts. Basic knowledge of dentition and related alpha and numeric numbering system. Knowledge of ICD-10, CPT and/or CDT-3 codes.
Experience with patient registration, scheduling and set up/ explanation of business contracts.
Demonstrated accuracy in AR and cash balancing.
Proven accuracy in reconciliation of patient accounts and strong attention to detail.
Experience using Edge software.
Internal Number: 328003
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.
BACK TO TOP
The mission of the University Risk Management and Insurance Association is to advance the discipline of risk management
in higher education.