Accounts Receivable Tech 3 - Must have a NM Residence

UNM Medical Group•Albuquerque, NM

13d•Remote

About The Position

UNM Medical Group, Inc. is seeking a full-time Accounts Receivable Tech 3 to join our Revenue Department. This is a Remote Position. The selected candidate must have a permanent address and live in New Mexico or be willing to relocate to New Mexico. The Accounts Receivable Tech 3 will be posting receipts into our billing system from EOP (Explanation of Payment) from insurance companies and patient payments. We utilize electronic postings from 835's as well as manual posting. We measure staff by a weekly average of productivity measurements and quality checks to ensure we are meeting the timing requirements with accuracy. Experience in cash applications in a healthcare setting is required. We are a Work From Home department meaning that we train initially Face to Face and then on Zoom and/or Teams and work Monday to Friday on a schedule that meets the Business Needs of the Organization and hopefully the needs of the Employee. We have weekly team meetings and monthly 1:1 meetings for review of productivity and quality. While we receive many Receipts (deposits/payments) from many different insurance companies, each poster will start with a few insurances and master those and then be introduced to others until the employee can post most payers. While this is based on individual experience it is a 4 - 7 month process. In addition, this position works credits or overpayments from insurance companies and/or patients as they post. We also have QC's which are system quality checks programmed into the Billing System that will flag the poster if something looks off. These QC's are run after each batch and corrected prior to completing each batch. Summary Under general supervision, performs a variety of complex functions to resolve involved billing problems and issues, and maintains appropriate ledgers. 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 staff, as appropriate.

Requirements

High school diploma or GED with at least 3 years of experience related to the duties and responsibilities specified.
Experience in cash applications in a healthcare setting is required.
Must have a permanent address and live in New Mexico or be willing to relocate to New Mexico.

Nice To Haves

Knowledge of posting payments and resolving denials via 835/EOB/EOP.
Collecting and/or posting payments.
Processing claims/bills/invoices.

Responsibilities

Posting receipts into the billing system from EOP (Explanation of Payment) from insurance companies and patient payments.
Utilizing electronic postings from 835's as well as manual posting.
Analyzing and investigating reimbursements or refund requests from third party payers, such as Medicare, Tricare, Medicaid, Salud, HMO’s, and other payers, to determine if contracted amount has been allowed.
Researching and analyzing third party payer remittance documentation to determine priority of payment and application of adjustments.
Using MPV Contract Management to assure proper refund/reimbursement.
Compiling and submitting appeals and monitoring for proper reimbursement.
Performing daily and monthly reconciliations to the general ledger, to include reclassifications; receiving and balancing documents of deposits received.
Researching and analyzing third-party payer remittance documentation in order to reconcile payments to remittance advices.
Reconciling and applying changes and corrections to patient invoices and accounts in order to resolve complex credit balances.
Following up directly with third-party payers and or patients, either by telephone or in writing, to resolve payment posting issues.
Ensuring strict confidentiality of patient medical and financial records, in compliance with federal and state patient privacy legislation.
Interfacing with other departmental representatives in the resolution of identified problems and issues.
Participating in the development and execution of departmental goals and objectives.
Providing task-specific support and guidance to others in the department, as appropriate.