Accounts Receivable Representative

University of Chicago • Burr Ridge, IL

1d • Hybrid

About The Position

The University of Chicago Physician’s Group (UCPG) is the central organization that supports the clinical activity of approximately 800 physicians at the University of Chicago. UCPG provides physician revenue cycle management for medical services provided by University physicians and also manages the University of Chicago Health Plan (UCHP). The University of Chicago Practice Plan (UCPP) is the central organization that supports the clinical activity of nearly 750 clinically active faculty practicing at the University of Chicago. These clinically active faculties collectively form the University of Chicago Physicians Group (UCPG) which is located in Burr Ridge, IL. The University of Chicago Physicians' Group (UCPG) is a component of the physician practice plan for the University of Chicago. The UCPG department provides billing services for medical services provided by University physicians and manages the accounts receivable and reporting processes for the Biological Sciences Division (BSD) departments. Each physician is a faculty member and is based in a specified department in the BSD. The Accounts Receivable Representative is responsible for supporting physician revenue cycle operations by performing routine accounts receivable (AR) follow up and denial resolution activities. This role ensures timely and accurate claim processing, payment collection, and reduction of outstanding AR. The representative communicates with internal departments, patients, and payers to obtain necessary information, resolve claim issues, and support efficient billing operations. They address denials and unpaid claims by researching issues, applying established workflows, and escalating complex cases as appropriate. The position maintains assigned work queues, documents actions clearly, and contributes to overall team productivity and quality standards. The representative may also assist with basic reporting, participate in training activities, and support process improvements as directed.

Requirements

• High School diploma required.
• Background with physician revenue cycle specific AR follow-up and denial resolution required.
• Working knowledge using physician billing/revenue cycle software and electronic medical records systems required.
• Proficient with physician revenue cycle specific AR follow-up and denial resolution required.
• Accomplished in diagnosis and CPT coding terminology required.
• Skillful in charge correction activities required.
• Diagnosis and CPT coding terminology required.
• Charge correction activities required.
• Critical thinking skills to review/compare information and form conclusions is required.
• PC experience and MS Office (Word, Excel, PowerPoint) required.
• Demonstration of effective interpersonal skills necessary to develop effective working relationships with both internal and external customers is required.

Nice To Haves

• Degree in business, finance, administration, or related field preferred.

Responsibilities

• Oversees the AR follow-up and denial resolution process with minimal direct oversight while also proactively reviewing current workflows for AR resolution with the intent to improve, implement, communicate and maintain an efficient AR resolution process.
• Identifies and resolves the systematic and/or operational root causes of denials and outstanding AR.
• Oversees and manages the AR follow-up work queues (WQ) and proposes both short and long-term enhancements that support business needs.
• Assists manager with maintaining payer scorecards, creating payer meeting agendas, and communicating issues to provider representatives.
• Works with the payers on escalated account resolution, identifies and submits high-complexity and other escalated payer projects, proactively reviews payer communication, initiates payer policy and rule change implementation, and proposes changes to front-end or back-end edits.
• Creates simple to moderately-complex reports that are necessary for payor projects using a variety of business tools.
• Communicates clearly and professionally with the other UCPG units, clinical departments, external vendors, and payers in order to build partnerships that result in denial resolution and prevention.
• Provides AR follow-up expertise to other UCPG and UCM business units as needed.
• Works closely with the Coding Education team to suggest opportunities for coder and provider training.
• Assists clinical departments in resolving escalated AR and denial issues.
• Works with Hospital Billing (HB) team on AR issues that cross between PB, HB, or SBO applications.
• Provide AR follow-up training to existing and new AR follow-up staff.
• Complete quality audits for denial and AR resolution activities.
• Create denial Appeal, Reconsideration, and Medical Necessity letter templates and trains staff in effectively using these templates.
• Create workflows and assists manager in developing and documenting policies and procedures.

Benefits

• The University of Chicago offers a wide range of benefits programs and resources for eligible employees, including health, retirement, and paid time off.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees