Accounts Receivable Specialist- Remote

UHS•Reno, NV

9d•Remote

About The Position

Independence Physician Management (IPM) was formed in 2012 as the physician services unit. IPM develops and manages multi-specialty physician networks and urgent care clinics within the Acute Care and Behavioral Health Divisions. A subsidiary of UHS, IPM operates in 13 markets across 7 states – and counting. We help doctors manage their practices and clinical procedures so they can concentrate on caring for their patients. This role requires a 3 month training period in office if you live within commuting distance to the King of Prussia, PA headquarters. Successful candidate must live in one of these locations: Pennsylvania, Florida, Texas, Nevada. The Accounts Receivable Specialist is responsible for the accurate and timely follow-up of unpaid and underpaid claims by assigned payer/s and defined aging criteria to meet or exceed collection targets and minimize write-offs. Researches claim denials by assigned payer/s to determine reasons for denials correcting and reprocessing claims for payment in a timely manner. Meets or exceeds the department’s established performance targets (productivity and quality). Initiates and follows-up on appeals. Exercises good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedites the reprocessing of claims and maximizes opportunities to enhance front end claim edits to facilitate first pass resolution. Identifies uncollectible accounts and performs accurate and timely write-offs (e.g. no authorization) adhering to IPM CBO policy guidelines. Demonstrates the ability to be an effective team player. Upholds “best practices” in day-to-day processes and workflow standardization to drive maximum efficiencies across the team.

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.