Claim Resolution Representative III Job at University of Rochester (Albany)

Claim resolution representative iii

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

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
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

Fulltime

Claim Resolution Representative III

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

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
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

Fulltime

Claim Resolution Representative III

With latitude for initiative and independent judgment within department guidelin...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree in business administration required
2 years of hospital/professional Patient Accounting, Consumer Collections experience, or Certification obtained from a nationally accredited billing program (i.e., Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical Reimbursement Specialist CMRS) required
Or an equivalent combination of education and experience
Ability to type 25 wpm Required

Job Responsibility

Managing professional hospital accounts
Resolving balances of aged insurance accounts
Making independent decisions as to the processes necessary to collect denied insurance claims, no response accounts, and investigating resolving billing issues
Maintaining a detailed knowledge of billing requirements and regulations
Representing the department and Strong Memorial Hospital (SMH) in a professional manner, protecting confidentiality of patient information
Completes follow up activities on denied, unpaid, or under-paid accounts
Maintains a thorough knowledge of Professional Billing
Identify and clarify billing issues, payment variances and/or trends that require management intervention
Research and respond to third party correspondence, receive phone calls, explain policies and procedures
Participate in department staff meetings, education classes and training

Fulltime

Claim Resolution Representative III

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

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
Completes follow up activities on denied, unpaid, or underpaid accounts
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

Fulltime

Claim Resolution Representative III, Hospital/Private

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

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
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

Fulltime

Claim Resolution Representative III, Hospital/Private

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Albany

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

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
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

Fulltime

Claim Resolution Representative III, Hospital/Private

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 2 years of relevant experience required
Or equivalent combination of education and experience

Job Responsibility

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
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

Fulltime

Claims Resolution Representative III

The Claims Resolution Representative III is responsible for working across the p...

Location

United States of America , Albany

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate degree and 2 years of related relevant experience
or equivalent combination of education and/or experience
Excellent problem-solving skills
Excellent communication skills
Excellent customer service skills

Job Responsibility

Follows department policies and procedures and maintains and exercises comprehensive knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivable
Follows up on multi-faceted denials through review of remittances (EOBs), insurance correspondence, rejections
Research claims, identify 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
Keeps management informed of changes in billing requirements and rejection or denial codes
Collaborates with Claim Edit Specialists and Patient Medical Billing Specialists

Fulltime

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Claim Resolution Representative III

Job Description

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Claim Resolution Representative III

Claim resolution representative iii

Claim Resolution Representative III

Claim Resolution Representative III

Claim Resolution Representative III

Claim Resolution Representative III, Hospital/Private

Claim Resolution Representative III, Hospital/Private

Claim Resolution Representative III, Hospital/Private

Claims Resolution Representative III

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