Clm Resltion Rep II, Hosp/Prv

University of Rochester•Rochester, NY

87d•$20 - $27•Remote

About The Position

The University of Rochester is committed to Meliora - Ever Better, embodying values of equity, leadership, integrity, openness, respect, and accountability. This role is a full-time position within the United Business Office, working 40 hours per week on a day shift. The Claims Resolution Representative II is responsible for working across the professional fee organization, performing routine follow-up activities designed to bring all open account receivables to successful closure. The primary goal is effective claims follow-up to obtain maximum revenue collection. Responsibilities include researching, correcting, resubmitting claims, submitting appeals, and taking timely action to resolve unpaid claims. The position reports to Accounts Receivable Management.

Requirements

High School diploma and 2 years of related work experience required

Nice To Haves

Associate degree preferred
Ability to problem solve preferred
Excellent communication skills preferred
Ability to put information into a keyboard while typing min of 25 wpm preferred.
Strong working knowledge of the professional billing software applications preferred
Excellent customer service skills preferred

Responsibilities

Follows department policies and procedures and maintains and exercises thorough knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivables, making any corrections in the professional billing system necessary to ensure balance resolution for all assigned URMFG physician services.
Follows up on denied accounts through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. Researches claims, identifies problems, and takes appropriate action to assure claim resolution.
Responds to all billing-related inquiries from colleagues, departments, patients, and payors in a timely and professional manner.
Communicates any missing/incomplete information to providers and department administrative support staff to ensure accurate billing.
Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of claims.
Follows established procedure for missing insurance payment information on claims.
Keeps management informed of trends.
Remains current on changes in billing requirements associated with claim processing and coding.
Escalate issues that may prevent completion of responsibilities to management.
May perform other duties as assigned.