Patient Accounts Receivable Representative I, Hybrid

Company Description

Renowned as the academic flagship of the University of Maryland Medical System, our Magnet -designated facility is a nationally recognized, academic medical center with opportunities across the continuum of care. Come join UMMC and discover the atmosphere where talents and ideas come together to enhance patient care and advance the science of nursing. Located in downtown Baltimore near the Inner Harbor and Camden Yards, you won’t find a more vibrant place to work!

Overview

Under general supervision, this position supports the vision and mission for the University of Maryland Medical Systems, a multi-billion dollar regional healthcare facility. Expectations include, but are not limited to, Insurance verification, evaluating the financial responsibility of patients, updating accounts to a billable/collectible status, researching denials, claim rejections, and delays in reimbursement, utilizing all possible means to resolve accounts, which include contacting patients, insurance companies and other departments. Assists the department by organizing collection procedures and meeting performance goals while adhering to current laws and payer regulations and reducing uncompensated care.

Key Responsibilities

• Works and maintains assigned receivables through work queues, age trail balance reports (ATBs), and special projects to achieve established department goals through the resolution of outstanding account balances and reduction of uncompensated care.
• Reviews financial references, including guidelines for reimbursement, state and federal regulations, payer-specific reimbursement policies, and procedures.
• Ensures correct processing of outstanding insurance claims by interpreting insurance payer responses, requesting account level adjustments, submitting appeals and claims reconsiderations, evaluating patients’ financial responsibility, resolving insurance denials and claim rejections, and performing insurance verification.
• Works with third-party insurance to obtain the maximum level of cash to reduce receivables.

Knowledge, Skills, And Abilities

• Effective verbal and written communication skills are necessary in dealing with a variety of healthcare and finance professionals, including senior management staff.
• Ability to handle confidential issues with integrity and discretion.
• Ability to work effectively in a matrix work environment and to manage multiple deadline-driven tasks and projects.
• Ability to operate a personal computer is required. Proficiency with the following applications is required: MS Excel, MS Word, and PowerPoint. MS Access, SAS, and Tableau is preferred.
• Concern for quality and ability to identify errors and implement corrections.
• Ability to prioritize and manage work in a stressful environment.
• Minimal knowledge or demonstrated ability to learn and understand HSCRC/CMS regulations, CPT (Current Procedural Terminology), and ICD-10 coding.

Qualifications

• 1 year work experience in general collections, accounts receivable oversight or customer service
• High School Diploma or equivalent (GED)

Preferred

• Associate’s degree in healthcare; courses in Accounting, Finance, Business Administration, and/or Healthcare Administration.
• Familiar with EPIC HB module
• Basic knowledge of insurance billing, collections, insurance or medical terminology; including CPT, ICD-10, HCPCS coding, EOB/EOP
• Institutional and/or Professional Healthcare Collections

Additional Information

All your information will be kept confidential according to EEO guidelines.