Accounts Receivable Specialist – REMOTE

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Company Overview

Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi?specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

Position Overview

The Accounts Receivable Specialist is responsible for the accurate and timely follow?up of unpaid and under?paid claims by assigned payers and defined aging criteria to meet or exceed collection targets and minimize write?offs. Researches claim denials by assigned payers to determine reasons for denials, correcting and reprocessing claims for payment in a timely manner. Meets or exceeds the departments established performance targets (productivity and quality). Initiates and follows up on appeals. Exercises good judgement in escalating identified denial trends or root causes 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.

Key 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 LCDs and NCDs 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.

Qualifications

• High School Graduate/GED required. Technical School/2 Years College/Associates Degree preferred.
• Work experience: 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.
• Understanding of the revenue cycle and how the various components work together preferred.
• 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.

Benefits

• A Challenging and rewarding work environment.
• Competitive Compensation & Generous Paid Time Off.
• Excellent Medical, Dental, Vision and Prescription Drug Plans.
• 401(K) with company match.
• and much more!

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

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