Account Operations Tech 3

UNM Medical Group • Albuquerque, NM

3d • Hybrid

About The Position

Under general supervision, performs a variety of complex functions to resolve involved billing problems and issues, and maintains appropriate ledgers. This includes handling patient customer service calls, responding to patient customer service inquiries and complaints, addressing patient billing questions and concerns, managing patient account resolution including filing insurance, and processing patient payments. Researches and provides reports on resolved invoices. Performs complex analyses of patient accounts, patient payments, and remittance advices from third-party payers; posts complex account adjustments, transfers, and other actions. Initiates correspondence to responsible parties or third-party payers, as applicable. Provides day-to-day guidance and mentorship to lower-level Patient Accounts Techs, as appropriate.

Requirements

• High school diploma or GED with at least 5 years of experience that is directly related to the duties and responsibilities specified
• Completed degree from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.
• Verification of education and licensure (if applicable) will be required if selected for hire.
• Hybrid Position-Selected candidate must have a permanent address and live in New Mexico or be willing to relocate to New Mexico.

Responsibilities

• Analyzes and investigates reimbursements from third party payors, such as Medicare, Champus, Medicaid, Salud, HMO's, and other payors, to determine if contracted amount has been allowed; researches and analyzes third party payor remittance documentation to determine priority of payment and application of adjustments.
• Reconciles and applies changes to patient invoices and account to correct account issues; initiates inquiries, either by phone or in writing, to third party payors, and/or patients to resolve reimbursement and credit balance issues.
• Responds to requests from third party payors and/or patients regarding reimbursement problems and issues.
• Interacts with and advises internal staff regarding billing and documentation policies, procedures, and serves as liaison with other department representatives to resolve reimbursement and/or credit balance issues.
• Prepares adjustment and refund request forms.
• Collects, analyzes, and summarizes data for preparation of statistical reports; creates and maintains specified data files and logs, maintains computerized systems for collection and tracking of data, and assists in the preparation of reports.
• Ensures strict confidentiality of patient medical and financial records, in compliance with federal and state patient privacy legislation.
• Assists in departmental problem solving, project planning, and the development and execution of departmental goals and objectives.
• May provide task-specific support and guidance to other techs, as appropriate.

Benefits

• Competitive Salary & Benefits
• Insurance Coverage : Includes medical, dental, vision, and life insurance.
• Additional Perks : Offers tuition reimbursement, generous paid time off, and a 403b retirement plan for eligible employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED