Denial and Underpayment Spec

Loma Linda University
San Bernardino, California

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Employment Type
Full Time
Institution Type
Four-Year Institution
Denial and Underpayment Spec🔍San Bernardino, California📁Clerical/Office Support💼Loma Linda Unv Shared Services📅22002125 Requisition #Shared Services: Billing/Collections - (Full-time, Day Shift) -

Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.

The Denials and Underpayment Specialist is responsible for the complete analysis, auditing and recovery of accounts. Thorough understanding of the LLUMC commercial payers, contracted payers, and managed care payers is required to successfully collect maximum reimbursement. Reports to management any gross payment discrepancies by payers, and makes contractual adjustments when necessary. Reports to outside payers any incorrect payments received. Responsible for reporting repeated payment error by outside entities to management. Audits closed accounts for possible payment errors and subsequent appeals. These services may be provided for both the LLUMC and LLUCH hospitals. Performs other duties as needed.

High School Diploma or GED required. Associate's Degree preferred. Minimum two years of experience in hospital UB04 billing, auditing and collections required. Minimum one year of experience in an acute hospital patient account setting required.

Familiar with automated billing, follow-up and adjudication systems required (i.e., Emdeon, MedAssets, HIPAA, FCA, etc.). Knowledge of UB04, CPT, HCPC, ICD9, and EOB required. Able to keyboard 40 wpm and 10-key.. Able to read, write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.

Additional Information
  • Organization: Loma Linda Unv Shared Services
  • Employee Status: Regular
  • Schedule: Full-time
  • Shift: Day Job
  • Days of Week: Monday, Tuesday, Wednesday, Thursday, Friday

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