University of Utah Job Description
Reviews Explanation of Benefits (EOBs), incoming insurance checks, and remittance advice received from payors to ensure accurate distribution and posting of payments to accounts. Audits to ensure that bills are correct and all required billing documents are available. Performs account maintenance and follow-up.
Two years of accounting or medical insurance claim experience or equivalency (one year of education can be substituted for two years of related work experience); a basic understanding of debits and credits, word processing, spreadsheet, and ten-key by touch skills, strong analytical skills, and effective verbal and written communication and human relation skills required.
Familiarity with commercial or government billing requirements and knowledge of insurance, coding, and medical terminology is preferred.
This position is not responsible for providing patient care.
Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.
This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.
Insurance Account Representatives follow Hospital, insurance, and Medicare policies and procedures. Within the framework of policy, the incumbent may decide which account balances are correct, which accounts should be written off up to a specified dollar limit, which payments are correctly posted, and which payments need to be reversed.
Challenges encountered include obtaining correct information on patient accounts, verifying patient information, and using appropriate channels to ensure timely receipt of payments. The incumbent must ensure that billing requirements, transaction codes, adjustments, and charges are correct, and maintain current knowledge of billing and insurance requirements that vary from payor to payor. The Insurance Account Representative must accurately process a high volume of payments and ensure frequent deadlines are met.
Depending on the area of assignment, incumbents may focus efforts on payment posting or billing.
Work Environment and Level of Frequency typically required
Nearly Continuously: Office environment.
Physical Requirements and Level of Frequency that may be required
Nearly Continuously: Sitting, hearing, listening, talking.
Often: Repetitive hand motion (such as typing), walking.
Seldom: Bending, reaching overhead.
250 East 200 South, Suite 125,
Salt Lake City, Utah 84111
Phone: 801.581.2169 Email: AskHR@utah.edu
© 2023 THE UNIVERSITY OF UTAH