URO Shared Service Center Representative
Trinity Health - Novi, Michigan - Boise, ID

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POSITION PURPOSE
The Billing & Follow-Up Representative reviews, researches, and processes claims in accordance with contracts and policies to determine the extent of liability and entitlement, as well as to adjudicate claims as appropriate. The core responsibilities will include: coding and processing claim forms; reviewing claims for complete information, correcting and completing forms as needed; accessing information and translating data into information acceptable to the claims processing system; and preparing claims for return to provider/subscriber if additional information in needed. Additional follow-up responsibilities include: maintaining all appropriate claims files and following up on suspended claims; assisting, identifying, researching and resolving coordination of benefits, subrogation, and general inquiry issues, then communicating the results; and preparing formal history reviews.

MINIMUM QUALIFICATIONS
High school diploma or an equivalent combination of education and experience. Associate degree in accounting or business administration high desired. Data entry skills (50-60 keystrokes per minutes). Past work experience of at least one year within financial services setting, performing medical claims processing, financial counseling, accounting, financial clearance and/or customer service activities is required. Previous work experience of at least one year of a health care setting is strongly preferred. Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is strongly preferred. Working knowledge of medical terminology, anatomy and physiology, medical record coding (ICD-9, CPT, HCPCS), and basic computer skills are highly desirable. Excellent communication (verbal and writing) and organizational abilities. Interpersonal skills are necessary in dealing with internal and external customers. Accuracy, attentiveness to detail and time management skills are required. To successfully accomplish the essential job functions of this position, the incumbent will be required to work independently, read, write, and operate keyboard and telephone effectively. Must be comfortable operating in a collaborative, shared leadership environment.

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