Description
:
DMC University Laboratories (DMCUL)is committed to providing exceptional patient care in a supportive and collaborative environment. As a member of our team, you will have the opportunity to work with advanced technology and be part of a healthcare community dedicated to making a positive impact on the lives of our patients.
Benefits StatementAt Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
· Medical, dental, vision, and life insurance
· 401(k) retirement savings plan with employer match
· Generous paid time off (PTO)
· Career development and continuing education opportunities
· Health savings accounts, healthcare & dependent flexible spending accounts
· Employee Assistance program, Employee discount program
· Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.
Note: Eligibility for benefits may vary by location and is determined by employment status
Summary DescriptionUnder general supervision and according to established policies and procedures, submits Third party claim forms electronically and /or manually for professional and /or technical laboratory services. Monitors and corrects claims and takes the necessary actions to facilitate claim submission, including correction of information and insurance verification. Processes overpayments and insurance takebacks by analyzing accounts to determine cause and appropriateness utilizing published guidelines by the Third-Party Payor. Completes all required claim form corrections and actions to facilitate resolution of credit balance or payment of claim. Posts appropriate denial management code on the patient's account to identify Third-Party front-end rejection. Processes post-billing insurance charges and post billing adjustments, discounts, and charity care allowances according to the terms of Third-Party contracts. Performs detail analysis of accounts after initial billing in order to obtain timely reimbursement, maximum collections, and account resolution. Interprets Third Party regulations in order to correct denial management rejections. maintains consistent execution of departmental process flows to ensure no operational write-offs adjustments occur within area of accountability. Initiates timely account receivable management follow-up steps with appropriate payors for reimbursement. Utilize on-line Third-Party Billing Systems to determine claim status. Review and analyze credit balance, submit adjustments claims or disbursement form for overpayments. Identify cash posting error on credit balances unrelated to an insurance overpayment, adjust balance using the correct accounts receivable transaction code. Process third party denials received via hardcopy, EOB's , letters or remittance advice. Make appropriate correction and initiate rebill to third party payor. Receives payments and post according to established guidelines. Balances, verifies and sorts payments via the bank lockbox. Researches, identifies and assigns appropriate transaction codes and general ledger account numbers to ensure the accuracy and integrity of the general ledger. Prepares bank deposits. Performs a variety of accounting analyses and reconciliations. Reviews and codes cash receipt documentation to ensure inclusion of patient account number, insurance plan code, and service code. Validates and applies electronic payment remits, as well as, reimbursement amounts, contractual allowances, proration adjustments and rejection/denial codes. Analyzes residual balance to determine cause and enters appropriate transaction to either resolve the balance or refers the account for insurance or collection processing. Enters transaction to initiate secondary billing if no residual balance exists. Monitors Third Party contract compliance. Reconciles/balances cash posted amounts to control totals received. Calculates and records incoming cash totals by service codes. Reviews voucher classification and processes payment reclassification as necessary. Assists with special projects and other related duties as assigned.
Qualifications
:
· High School diploma or equivalent. Associate degree or equivalent combination of education and experience is highly desirable.
· Two to three years of patient accounting experience in Third party billing utilizing a computerized billing system.
Facility DescriptionDMC University Laboratories (DMCUL) is a regional, integrated laboratory system providing services to the eight hospitals of Detroit Medical Center. DMC University Laboratories evolved in 1993 and is comprised of Core Laboratories, Specialty Laboratories, two rapid response hospital laboratories, Centralized Stat Lab, Centralized Blood Bank Lab, and full service outreach infrastructure which includes patient service centers, remote ambulatory laboratories, marketing staff, courier system and billing department. The DMC University Laboratories service area covers the entire Southeast Michigan market and is growing at a rapid pace with the following outstanding features: Test menu of over 1,000 tests, which includes high end specialty tests. Less than 1% of our tests are sent to outside refe
