Claim Resolution Representative IV Job at University of Rochester (Rochester)

Claim resolution representative iv, hospital/private

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

Location

United States of America , Rochester

Salary:

20.99 - 28.34 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 3 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 and obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Mentors and trains new or lower level staff
Independently determines the most effective method to follow up on disputed, unpaid, underpaid, or overpaid insurance or contracted service accounts
Identifies and resolves problems related to primary and secondary accounts which are disputed, unpaid, underpaid or overpaid
Acts as a resource for questions from assigned collection and billing staff on payer policies, procedures and methods of revenue collection
Trains new staff on the use of the billing application, payer systems, and clearinghouse systems
Researches and responds to clinical department inquiries on complex, high dollar, and specialized accounts and status of collection activities
Resolves accounts identified in third party audits involving retroactive approvals, resulting in adjustments, refunds, and subsequent secondary billing
Identifies need for in-person meetings and phone conferences with third party insurance representatives due to claim and system issues

Fulltime

Claim Resolution Representative IV, Hospital/Provider

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

Location

United States of America , Rochester

Salary:

20.99 - 28.34 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 3 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 and obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Mentors and trains new or lower level staff
Independently determines the most effective method to follow up on disputed, unpaid, underpaid, or overpaid insurance or contracted service accounts
Identifies and resolves problems related to primary and secondary accounts which are disputed, unpaid, underpaid or overpaid
Acts as a resource for questions from assigned collection and billing staff on payer policies, procedures and methods of revenue collection
Trains new staff on the use of the billing application, payer systems, and clearinghouse systems
Researches and responds to clinical department inquiries on complex, high dollar, and specialized accounts and status of collection activities affecting departmental revenue
Resolves accounts identified in third party audits involving retroactive approvals, resulting in adjustments, refunds, and subsequent secondary billing
Identifies need for in-person meetings and phone conferences with third party insurance representatives due to claim and system issues requiring prompt attention for complex high dollar accounts

Fulltime

Claims Resolution representative iv

Wilmot Cancer Institute is looking for an experienced, compassionate, and detail...

Location

United States of America , Brockport

Salary:

20.99 - 28.34 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree in Business Administration and 2 years of hospital patient accounting or consumer collections experience
or an equivalent combination of education and experience
Ability to type 25 wpm
Experience working with transplant programs including, but not limited to transplant contracting, transplant provider relations, transplant billing and collections, etc.
Must be able to multi-task and pivot across duties as needed

Job Responsibility

Acts as billing and collections resource
Completing National Marrow Donor Billing
Responsible for resolving Work Queues in EPIC
Research and analyze denials
Routinely works hospital reports to ensure claims are sent timely
Edits follow up bills originated by EPIC
Responsible for communicating with insurance companies, other payers, and patients
Trains all claims resolution specialists that join the WCI Business office

Fulltime

Claim Resolution Representative IV, Hospital/Provider

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

Location

United States of America , Rochester

Salary:

20.99 - 28.34 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 3 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 and obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Mentors and trains new or lower level staff
Independently determines the most effective method to follow up on disputed, unpaid, underpaid, or overpaid insurance or contracted service accounts
Identifies and resolves problems related to primary and secondary accounts which are disputed, unpaid, underpaid or overpaid
Acts as a resource for questions from assigned collection and billing staff on payer policies, procedures and methods of revenue collection
Trains new staff on the use of the billing application, payer systems, and clearinghouse systems
Researches and responds to clinical department inquiries on complex, high dollar, and specialized accounts and status of collection activities
Resolves accounts identified in third party audits involving retroactive approvals, resulting in adjustments, refunds, and subsequent secondary billing
Identifies need for in-person meetings and phone conferences with third party insurance representatives

Fulltime