Clm Resltion Rep II, Hosp/Prv

University of Rochester • Rochester, MN

5d • $20 - $27 • Onsite

About The Position

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. This role is crucial for effective claims follow-up to obtain maximum revenue collection. Responsibilities include researching, correcting, resubmitting claims, submitting appeals, and taking timely and routine action to resolve unpaid claims. The Claims Resolution Representative II reports to Accounts Receivable Management.

Requirements

• High School diploma and 2 years of related work experience Or equivalent combination of education and experience.

Nice To Haves

• Strong working knowledge of the professional billing software applications
• Excellent customer service skills

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. Research 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.

Benefits

• The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be set by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED