University of Rochester
Location
Rochester, Minnesota
Salary
$20 - $26 / HOUR
The role involves performing follow-up activities to successfully close all open account receivables and ensuring effective claims follow-up to maximize revenue collection. Responsibilities include researching, correcting, resubmitting claims, submitting appeals, and resolving complex unpaid claims while acting as a resource for junior staff.
Candidates must have an Associate's degree and 2 years of relevant experience, or an equivalent combination of education and experience. The position requires resolving complex claims, handling payer communications, and documenting actions taken in the electronic health record.
Performs follow-up activities designed to bring all open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. Resolves complex claims. Acts as a resource for lower level staff.
Rochester Tech Park (RTP), Gates, NY - Remote options available after in-person training. Occasional onsite meetings / work at RTP are required. Remote location must be within 2 hours of RTP and within New York State. ESSENTIAL FUNCTIONS Completes follow up activities on denied, unpaid, or underpaid accounts, as well as contacts payer representatives to research and resubmit rejected claims to obtain and verify insurance coverage. Follows up on unpaid accounts working claims. Reviews reasons for claim denial. Reviews payer website or contacts payer representatives to determine why claims are not paid. Determines steps necessary to secure payment and completes and documents follow up by resubmitting claim or deferring tasks. Researches and calculates under or overpaid claims; determines final resolution. Contacts payers on incorrectly paid claims completing resolution and adjudication. Adjusts accounts or processes insurance refund credits. Reviews and advises leadership on incorrectly paid claims from specific payers. Works with leadership on communication to payer representatives regarding payment trends and issues. Bills primary and secondary claims to insurance. Identifies and clarifies billing issues, payment variances, and/or trends that require management intervention. Assists department leadership with credit balances account reviews/resolutions and all audits. Coordinates response and resolution to Medicaid and Medicare credit balances. Requests insurance adjustments or retractions. Reviews and works all insurance credits in electronic health record. Enters electronic health record notes, documenting actions taken. Researches and responds to third party correspondence, receives phone calls, and explains policies and procedures involving routine and non-routine situations. Assists with patient related questions. Communicates and coordinates with other departments to resolve claim issues. Assists with all audits as needed. Other duties as assigned. MINIMUM EDUCATION & EXPERIENCE Associate's degree and 2 years of relevant experience required Or equivalent combination of education and experience The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.
If you are a Current Employee, please log into myURHR to search for and apply to jobs using the Jobs Hub. Your application, if submitted using this portal, cannot be moved forward. Learn. Discover. Heal. Create. Located in western New York, Rochester is our namesake and our home. One of the world’s leading research universities, Rochester has a long tradition of breaking boundaries—always pushing and questioning, learning and unlearning. We transform ideas into enterprises that create value and make the world ever better. If you’re looking for a career in higher education or health care, the University of Rochester may offer the perfect opportunity for your background and goals. At the University of Rochester, we are committed to fostering, cultivating, and preserving an inclusive and welcoming culture and are united by a strong commitment to be ever better—Meliora. It is an ideal that informs our shared mission to ensure all members of our community feel safe, respected, included, and valued.
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