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Support Services Specialist

Company: University of Iowa
Location: Iowa City
Posted on: September 8, 2019

Job Description:

Schedule: Monday Friday, 8:00am 5:00pm
Job Duties:
Performs business functions to support the College of Dentistry Revenue Cycle; duties include claim submission and Accounts Receivable management, cash collection, financial counseling and insurance verification.
Provide Support Services to Clinical and Non-clinical Departments

  • Provides financial counseling to students and patients regarding estimated Insurance coverage and resulting patient out of pocket amounts. Requests down payments according to College of Dentistry policy. Advises provider of available benefit to maximize insurance when treatment stretches over the benefit year.
  • Approves student lab orders if required down payment (as per COD requirements) has been secured; documents same in PAS and posts payment as pre-payment toward applicable planned treatment.
  • Assists with daily Medicaid verification processes as needed. Runs various reports to ascertain Medicaid status relative to upcoming appointments; updates Patient Accounting System (PAS), notifies providers, patient managers and clinical staff of changes in benefits which could impact treatment decisions.Communicate/Collaborate with Internal and External Constituents
    • Shares information with team when subject matter is applicable to departmental operations.
    • Reviews eligibility and available benefits for upcoming appointments and informs College of Dentistry providers and program managers of insurance coverage lapses or maxed benefits; this is vitally necessary for the successful delivery of care to our Medicaid population and the prevention of lost revenue for the College.
    • Participates in meetings; listens when receiving new information; adds to discussion to share experiences related to topic. Treats others with respect at all times.
    • Responds to and resolves patient questions regarding balances and delivery of care: directs escalated complaints to supervisor or patient representative as needed.Human Resources Management
      • Actively participates in our students education by enhancing their understanding of the business aspect of Dentistry; teaches them how to check insurance eligibility and benefits and apply this knowledge to arrive at an affordable treatment plan for their patient. Informs providers of documentation required to ensure successful adjudication of dental/medical insurance claims.
      • Provides mentoring to new and existing staff regarding 1) accurate insurance registration procedures utilizing multiple insurance and clearinghouse websites and accurate entry into PAS and 2) University of Iowa Cash Handling policies and procedures. Provides quality control feedback to applicable staff throughout the course of their training and beyond as approved by supervisor. Constructs and provides job aids to acclimate new and established employees to Revenue Cycle functions and responsibilities.
      • Source of information and guidance for student employees relative to insurance verification and various business office processes.
      • Serves as a resource for correct business processes for staff and providers throughout the College.Financial Management
        • Forwards requests for preauthorizations and claim appeals to appropriate business office employees.
        • Collects patient balances and down-payments and records same in patient accounting system (PAS). Balances cash collections to Patient Accounting System (PAS) for self and department as a whole. Provides quality control feedback to appropriate staff when applicable and approved by supervisor.
        • Prepares daily cash deposit for courier pick up.
        • Serves as back up for daily collection report to Credit Bureau Services of Iowa, Inc., and electronic posting of lockbox and web portal payments.
        • Obtains and registers insurance information and secures all necessary signatures. Prepares treatment for submission to insurances.
        • Monitors quality control reports to manage prepayments and insurance registration; takes appropriate action in PAS to ensure correct patient statement and insurance claim production. Provides quality control feedback to appropriate staff when applicable and approved by supervisor.
        • Sets up monthly payment plans according to College of Dentistry guidelines. Monitors patient accounts and contacts patient/guarantor when accounts are delinquent.
        • Using College of Dentistry guidelines initiates refunds of patient and/or insurance credits created throughout the course of treatment.Job opening are posted for a minimum of 14 calendar days. This job may be removed from posting and filled any time after the minimum posting period has ended.
          Successful candidates will be subject to a criminal background check.

          REQUIRES:
          • Bachelors degree or an equivalent combination of education and relevant experience is required.
          • 6 months 1 year relevant experience in a medical/dental business office with financial counseling, cash collection, knowledge of insurance claim processing requirements/adjudication experience and strong customer service skills including the following skillsets:KNOWLEDGE OF HEALTH AND/OR DENTAL CARE REIMBURSEMENT Basic Experience
            Knowledge of the full spectrum of activities, practices, tools, and considerations for managing health and/or dental care reimbursement processes.
            • Can identify the major activities of the patient revenue management function and explain to customer/patient.
            • Understands basic principles, techniques and terminology of claims processing and reimbursement.
            • Can identify major types of coverage, associated claims and payment processes.
            • Is aware of the payer's claim settlement practices.KNOWLEDGE OF HEALTH AND/OR DENTAL CLAIMS Basic Experience
              Knowledge of the full spectrum of activities, practices, tools, and considerations for managing claims processing.
              • Can identify the major activities of the claims function.
              • Understands basic principles, techniques and terminology of dental and medical claims processing.
              • Can identify major types of coverage and associated claims.
              • Is aware of the company's claim settlement philosophy.HIPAA Knowledge and understanding of the Health Insurance Portability and Accountability Act Working Experience
                Knowledge and understanding of the Health Insurance Portability and Accountability Act.
                • Describes the implications of the law to own function.
                • Participates in implementing adherence to specific aspect of this law.
                • Describes major HIPAA-related challenges to the organization.
                • Identifies relevant procedures that demonstrate HIPAA adherence.
                • Describes types of plan conversions in compliance with HIPAA guidelinesHIGHLY Desirable:
                  • Experience with electronic health record/patient accounting system.
                  • Experience in a dental practice.Application materials should clearly indicate qualifications for advertised position.
                    Note to Applicant: Applicants should assure their application/resume and cover letter illustrate the work experience they have that demonstrates the qualifications and competencies listed above. Unless otherwise noted, the proficiency level required for the position is Basic Experience or Working Experience
                    • Basic Experience is defined as uses basic understanding of the field to perform job duties; may need some guidance on job duties; applies learning to recommend options to address unusual situations.
                    • Working Experience is defined as successfully completes diverse tasks of the job; applies and enhances knowledge and skill in both usual and unusual issues; needs minimal guidance in addressing unusual situations. The is the 1 st of 4 levels in the Support Services (PVD) job family

                      The University of Iowa is an equal opportunity/affirmative action employer. All qualified applicants are encouraged to apply and will receive consideration for employment free from discrimination on the basis of race, creed, color, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, religion, associational preference, status as a qualified individual with a disability, or status as a protected veteran.


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Keywords: University of Iowa, Iowa City , Support Services Specialist, Other , Iowa City, Iowa

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