Accounts Receivable Specialist

UHS•Tredyffrin Township, PA

57d•Remote

About The Position

Independence Physician Management (IPM) is seeking an Accounts Receivable Specialist to join their team. IPM, a subsidiary of UHS, manages multi-specialty physician networks and urgent care clinics. This role is responsible for the accurate and timely follow-up of unpaid and underpaid claims to meet collection targets and minimize write-offs. The specialist will research claim denials, correct and reprocess claims, and initiate appeals. They will also identify uncollectible accounts for write-offs according to IPM CBO policy. The role requires demonstrating teamwork and upholding best practices for efficiency. A 3-month training period in the King of Prussia, PA headquarters is required for those living within commuting distance. Successful candidates must reside in Pennsylvania, Florida, Texas, or Nevada.

Requirements

High School Graduate/GED required.
Experience (1-3 years minimum) working in healthcare revenue cycle
Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes
Excellent organization skills, attention to detail, research, and problem-solving ability.
Results oriented with a proven track record of accomplishing tasks within a high-performing team environment.
Service-oriented/customer-centric.
Strong computer literacy skills including proficiency in Microsoft Office.

Nice To Haves

Technical School/2 Years College/Associates Degree preferred.
Understanding of the revenue cycle and how the various components work together preferred

Responsibilities

Accurate and timely follow-up on claims that have not received a response, have been denied, or have been under/over paid.
Works with payer to determine reasons for denials.
Corrects and reprocesses claims for payment in a timely manner.
Proceeds with appeals process as needed.
Performs eligibility and claim status follow-up inquiries utilizing outbound calls to the payer, web link tools and payer websites.
Documents all actions taken on accounts worked according to the department policy to ensure clear understanding of encounter status.
Identifies root causes and denial trends and makes recommendations to department leadership to prevent additional denials.
Maintains a strong working knowledge of payer requirements and can research payer policies including LCD’s and NCD’s to help determine root cause for denial trends.
As a last resort after exhausting all efforts, performs accurate write-offs (e.g. no authorization) following the identification of uncollectible accounts.
Strictly adheres to IPM CBO write-off policies and procedures and utilizes proper adjustment aliases as defined in departmental job aides.
Participates in regularly scheduled team meetings sharing denial trends specific to claim requirements to enhance front end claim edits to facilitate first pass resolution.
Contributes ideas for workflows and approaches to A/R follow-up tasks to maximize opportunities for performance, process, and net revenue collections improvement.
Meets established productivity metrics for the AR Department.
Meets routinely with Supervisor to review productivity results and understands best practices and opportunities to create efficiencies in order to achieve maximum performance.
Meets established quality metrics for the AR Department.
Meets monthly with Supervisor to review quality results and collaborate on ways to improve scores.
Upon receipt of monthly QR report, corrects any errors identified.