Rebecca Butts

• Record billing statements and hauling information
• Send out billing
• Tax preparation
• File documents

Payment Audit Specialist Duties

Mail

· Check the mailbox in the mail room. Scan any audits to the group email address

· Mail also comes in through the email group of Clinical Documentation-AspirusInc-Payor Audit Letters PayorAuditLetters@aspirus.org.

· Check Lockbox for documents. Follow the Lockbox process for retrieving, printing, and posting of mail. See instructions in Payor Audit folder/Audit Specialist Training and Resources/Portals/JP Morgan Lockbox HealthLink 2.0 Update

· Prioritize mail, by type of audit, such as Government is high priority, larger $$, Home Health with EXL have 50 days and Humana MI non-contracted, UR esp BCBS of MI Medicare as non-contracted, and due dates of audits, and enter in to OnBase accordingly.

· New Audits – Enter into OnBase and start the process.

· Determinations from appeals – Update in OnBase and EPIC Account Notes

· Request(s) for medical records for audits - Send in an email to the HIM rep.

· Hospital charge audit notifications requesting a copy of the UB-04 and an Itemized Statement

· Refund requests – a lot of these will be forwarded to Denials team

· Do not enter anything in OnBase for Denials Team or Contract Management.

· NCCI edits- those get entered into OnBase and to Coding.

UHC AARP from Performant, NCCI edits, Medicare adjustments

· Inbox – This is where the audits come in from all entities within the Aspirus system and outside entities (i.e., insurance companies, auditors, etc.)

· Mail Completed – This is where the incoming emails, once entered into OnBase are put.

· FYI - this folder is where unique scenarios are stored, if someone from the Audit Team needs to see how one was handled.

· Humana Drug

· Anthem Medicaid E/Md

· HIM - This folder is used to keep the email correspondence around medical records/requests.

• Update information on claim forms
• Process claims

• Negotiate transactions in accordance with established laws, regulations, and policies
• Contact customers on accounts, including outbound customer contact when appropriate
• Update information on accounting in the loan servicing and/or consolidation systems
• Ensure integrity of date and information
• Perform other tasks related to resolving customer's needs, by displayed ownership on escalated calls

• Process Unemployment Insurance claims

• Fixed any mistakes found on products
• Placed an epoxy mixture on the threads of the rods

• Account receivable and payable, along with payroll
• Scheduling