Billing Research Processor I

Summary

The Medical University of South Carolina provides healthcare services through MUSC Community Physicians. The Billing Research Processor I researches, analyzes, and resolves undistributed and credit transactions in the EPIC system, including transfers, postings, offsets, and refunds. The role also verifies insurance and patient information, updates account records, processes refund requests, and maintains productivity and accuracy standards.

Responsibilities

• Undistributed/Overposted (credit) transactions. Process undistributed and credit transactions through assigned work queues or reports according to department’s workflows. Process all levels of transactions needed for resolution (transfers, posting, offsets, refunds, etc). Use available resources: Workflows, Email, Excel, Word, Fee Schedules etc. Verify insurance, patient, and guarantor information. Review websites, contact insurance carriers and/or guarantors and update demographics, coverage and/or claim information accordingly. Note accounts with actions taken
• Completed Contribution Average. Maintain department’s current Completed Account Contribution totals daily, weekly, monthly. (Productivity)
• Audits. Maintain >=97% accuracy rate on audit reviews
• HPF Insurance Refund Request Letters WQs. Review and process weekly to ensure resolution is met prior to deadlines stated in the request letters and/or set workflows and regulations
• Returned Refunds-Credit Processors will review; verify information pertaining to the reason of the return and/or consult with other departments when their refunds are returned for resolution. Process the cancelations to repost, reissue, and apply to escheatment or MISC Income for resolution

Skills

• High school diploma and one-year revenue cycle work experience required
• Must have excellent organizational, analytical, and communication skills
• Must be able to work independently under the direction of the Department Supervisor and Manager
• Continuous requirements are to perform job functions while standing, walking and sitting
• Ability to bend at the waist, kneel, climb stairs, reach in all directions, fully use both hands and legs, possess good finger dexterity, perform repetitive motions with hands/wrists/elbows and shoulders, reach in all directions
• Maintain 20/40 vision corrected, see and recognize objects close at hand and at a distance, work in a latex safe environment and work indoors
• Frequently lift and/or carry objects weighing 20 lbs (+/-) unassisted
• Lift from 36” to overhead 15 lbs
• Infrequently work in dusty areas and confined/cramped spaces
• High school diploma and one-year revenue cycle work experience required
• Prior account analysis, credit resolution, billing and/or insurance follow up experience in a hospital or physician office setting preferred with working knowledge of insurance payor remittances, and Epic system knowledge helpful
• Desired candidates are dependable; team focused, goal-oriented individuals with a strong work ethic and positive attitude

Qualifications

Must Haves

• High school diploma and one-year revenue cycle work experience required
• Must have excellent organizational, analytical, and communication skills
• Must be able to work independently under the direction of the Department Supervisor and Manager
• Continuous requirements are to perform job functions while standing, walking and sitting
• Ability to bend at the waist, kneel, climb stairs, reach in all directions, fully use both hands and legs, possess good finger dexterity, perform repetitive motions with hands/wrists/elbows and shoulders, reach in all directions
• Maintain 20/40 vision corrected, see and recognize objects close at hand and at a distance, work in a latex safe environment and work indoors
• Frequently lift and/or carry objects weighing 20 lbs (+/-) unassisted
• Lift from 36” to overhead 15 lbs
• Infrequently work in dusty areas and confined/cramped spaces
• High school diploma and one-year revenue cycle work experience required

Nice to Haves

• Prior account analysis, credit resolution, billing and/or insurance follow up experience in a hospital or physician office setting preferred with working knowledge of insurance payor remittances, and Epic system knowledge helpful
• Desired candidates are dependable; team focused, goal-oriented individuals with a strong work ethic and positive attitude

Benefits

• This position offers a remote work schedule