University of Michigan Health-Sparrow · 2 days ago
SMS-A/R SPECIALIST I
Lansing, MI
Full-time
Onsite
Entry Level
1+ years expUniversity of Michigan Health-Sparrow is seeking an SMS-A/R Specialist I to manage the billing process for Sparrow Medical Supply. This role involves processing claims, verifying insurance coverage, and resolving inquiries to support Accounts Receivable goals.
Hospital & Health Care
Responsibilities
Processes all components of the billing process, including insurance validation, claim edit list, claims, and re-submissions by using the TIMS database system daily
Validates insurance claims by running a daily Validation Report from the TIMS system or DIVER list and completes missing data by referring to the original Customer Service Representative’s paperwork
Processes a claim edit list weekly from the TIMS system; reviews the list for accuracy and completeness, including social security number and date of birth and quantities of product billed and corrects missing/incorrect information in TIMS system claims file
Verifies the appropriate use of modifiers
Prints out claims for mailing or electronically sends claim file to payor
If a claim is returned or rejected on a payment voucher because of insufficient information, corrects and resubmits claim within 30 days. Documents action in claim file
Uses DIVER database system to recover lost claims for resubmission to payor on weekly basis
Assists insurance companies or customers with billing questions, inquiries, explanations and provides additional information in writing, if necessary. Documents all conversations and actions taken in TIMS Notes System
Works closely with Documentation Specialist for outstanding Certificates of Medical Necessity (CMN’s). Communicates when documents are still needed
Works with QA Specialist for initial or recert authorizations as required by each insurance
Adheres to Corporate Compliance Policies including but not limited to current Medicare/CMS regulations
Qualification
Required
Minimum 1 year customer service or billing experience in medical field
High School diploma or GED
ICD-10 Coding Knowledge
Math and organizational skills
Demonstrates ability to use a keyboard as may be required to perform the essential duties of the job
Excellent communication skills, both verbal and written
Ability to use sound judgment
Demonstrated people-sensitive characteristics with a genuine desire to help others
Company
University of Michigan Health-Sparrow
As Mid-Michigan’s premier healthcare organization and the region’s largest private employer, University of Michigan Health-Sparrow provides quality care to hundreds of thousands of people each year.
5001-10000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase