Clm Resltion Rep IV, Hosp/Prv
$20.99 - $28.34 per hourUniversity of Rochester
As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.
Job Location (Full Address):
905 Elmgrove Rd, Rochester, New York, United States of America, 14624
Opening:
Worker Subtype:
Regular
Time Type:
Full time
Scheduled Weekly Hours:
40
Department:
500011 Patient Financial Services
Work Shift:
UR - Day (United States of America)
Range:
UR URC 206 H
Compensation Range:
$20.99 - $28.34
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
Responsibilities:
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.
Location: 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
Independently determines the most effective method to follow up on disputed, unpaid, underpaid, or overpaid insurance or contracted service accounts in order to bring about prompt account resolution and revenue collection from complex claims, high dollar claims, and specialized services. Identifies and resolves problems related to primary and secondary accounts which are disputed, unpaid, underpaid or overpaid. Determines cause of problem and initiatives corrective action through reviews of electronic medical records. Works to confer with external agencies. Analyzes accounts and determines if correct proration of revenue has been collected, using detailed understanding and application of all payer contracts. Contacts applicable agency, payer or department for resolution. Decides when resubmitting efforts are complete, including writing an appeal using applicable content and supporting documentation to appropriately influence the highest level of revenue.
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. Demonstrates how to apply the knowledge of payer contracts and resources to resolve disputed, unpaid, underpaid, or overpaid accounts. Provides feedback to leadership on results of training of new and existing staff. Provides input for performance assessments based on observation, questions, and quality reviews of work performed. Acts as area leader, when needed, including responding to payers, patients, and issues referred to the area from hospital departments or department representatives.
Researches and responds to clinical department inquiries on complex, high dollar, and specialized accounts and status of collection activities affecting departmental revenue. Assesses if/when patients are contacted. Resolves complex, high dollar, and specialized claim resolution issues due to coordination of benefits, eligibility issues, and authorizations.
Resolves accounts identified in third party audits involving retroactive approvals, resulting in adjustments, refunds, and subsequent secondary billing. Researches, verifies, and/or obtains authorizations post-claim submittal. Determines allocation of reimbursement applicable to multiple providers for global transplant payments and initiates transfer of money to each payer.
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. Prepares information for and attends meeting with third-party insurance representatives on claims and systems issues for scheduled in-person meetings and phone conferences regarding complex high dollar claims.
Identifies and clarifies issues that require management and intervention to avoid loss of revenue. Recommends filing of a formal complaint with the State's regulation commission or agency. Determines when to change the account to a self-pay financial class after a review of previous efforts has not resulted in revenue collection and further attempts would not be successful without patient intervention.
Researches and initiates suggestions to leadership to streamline processes and training materials. Performs coverage for other positions as needed. Performs administrative office tasks and maintains records.
Other duties as assigned.
MINIMUM EDUCATION & EXPERIENCE
Associate's degree and 3 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.
Notice: 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.
$20.99 - $28.34 per hour
Job Title The University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how ...SuggestedFull timeCasual workWork at officeLocal areaRemote workShift work$37k - $51k
As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how...SuggestedHourly payFull timeWork experience placementWork at officeLocal areaShift work$19.62 - $26.49 per hour
1 week ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity,...SuggestedFull timeWork at officeLocal areaRemote workShift work$19.62 - $26.49 per hour
University Of Rochester Admissions Center As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together...SuggestedHourly payFull timeWork at officeLocal areaShift work$17 per hour
...Office Clerk II, III or IV (Substitutes) (RSY 25-26) JobID: 439 Position Type: Non-Instructional Support and Clerical/ Office Clerk Date Posted: 4/3/2025 Location: Exceptional Children / Special Education Date Available: Continuous Recruitment Closing...SuggestedWork at office- ...Submit civil service application to ****@*****.*** The Webster Town Clerk/Tax Receiver's Office is seeking a part-time Office Clerk IV to assist the department in a temporary capacity over the next several months, with the possibility of an extension through the end...Temporary workPart timeWork at office
$19 - $22.5 per hour
...knowledge of assigned receivable systems iii. General knowledge of Medicare, Medicaid and insurance compliance issues preferred iv. Familiarity with ICD-9 diagnosis and procedure codes as well as CPT/HCPCS codes helpful v. Knowledge of UBO4 billing form and 150...Full timeWork experience placementWork at officeMonday to FridayDay shift$18.5 - $23.03 per hour
...Basic knowledge of medical billing, cording, collection processes, insurance policies and governmental regulation provision preferred iv. Knowledge of UBO4 billing form and 1500F05 specific payer requirements preferred v. Excellent problem solving, organizational and...Full timeWork at officeLocal areaDay shift$19.08 - $25.77 per hour
University Of Rochester Patient Financial Representative As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability...Hourly payFull timeContract workLocal areaShift work$18 - $23.81 per hour
Job Posting As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest ...Hourly payFull timeWork at officeLocal areaShift work$16.67 per hour
...faxing, and answering and routing phone calls. Qualifications: Currently hold the Monroe County Civil Service title of Office Clerk IV or be on the current Monroe County Civil Service Office Clerk IV eligible list Hours: Monday - Friday 7.5 hours/day, not including...Work at officeMonday to Friday$17.5 - $22.6 per hour
Switchboard Operator Highland Hospital is seeking an experienced switchboard operator to join the team. This position answers the main line to Highland Hospital and directs all incoming calls. Hours are Saturday & Sunday from 3pm-8:30pm and Monday-Wednesday from 5pm...Hourly payWeekend work$100k
...Weekly Pay - we pay our team a base pay and commission! · Advancement - 95% of our Sales Operations Managers started out as a Sales Rep Essential Duties and Responsibilities · Meet with prospective customers to educate, consult, inform, and sell the Bath Planet...Weekly payFull time- ...compensation with strong incentive potential which is linked directly to your ability to increase business within your assigned medical sales rep territory. The Medical Sales Representative will promote our innovative products to hospitals, urgent care facilities, nursing...Flexible hours
$91k - $147.2k
At Johnson & Johnson,we believe health is everything. Our strength in healthcare innovation empowers us to build aworld where complex diseases are prevented, treated, and cured,where treatments are smarter and less invasive, andsolutions are personal.Through our expertise...Full timeTemporary workLocal areaRemote workWorldwide- Insight Global is seeking a highperforming Strategic Sales Executive to support one of our innovative clients within the dental laboratory space. This individual will play a critical role in driving national sales growth and building strategic partnerships with dental ...
$180k - $190k
Asureworks Sales Executive Over 600 employees strong, Asure sees Human Capital Management (HCM) through the lens of entrepreneurs and executives with an owner's mentality. We help businesses develop their "Human Capital" to get to the next level, stay compliant, and...Temporary workLocal area$72k - $250k
Imagine Your Future with Us! Since 1971, Paychex has been at the forefront of simplifying HR, payroll, and benefits for American businesses. Our digital HR technology and advisory solutions cater to the changing needs of employers and their employees. With our award-winning...Base plus commissionFull timeContract workPart timeInternshipLocal area$90k - $140k
At Mindex, we're not just delivering software-we're helping organizations rethink what's possible with AI, cloud, and data. With more than 30 years of success, we've built a reputation for delivering real, measurable outcomes through agile development, cloud engineering...Work at officeLocal areaWork visaFlexible hours$42k
Sales Specialist Howell Studios is a premier, full-service marketing, advertising, and video production company serving clients across a variety of industries. Founded in 2010, we have grown into a leading creative agency known for delivering results-driven campaigns...Base plus commissionCurrently hiringNight shift$75k
Territory Sales Representative – Higher Education (Remote | Western NY) ECA Recruiters is partnering with a proven, mission-driven leader in higher education digital learning solutions to hire a Territory Sales Representative covering Western New York . This is an outside...Remote workNight shift$18 - $21 per hour
FASTSIGNS Customer Service Representative/Admin As a FASTSIGNS Customer Service Representative/Admin, you will be the initial contact with current customers as well as prospective customers. You will work with customers in numerous ways such as email, telephone, in-...Hourly payWork at officeWorldwide$22 - $27 per hour
Business Services Representative Here at GoNetspeed, we believe in the power of connectivity. We believe that life doesn't wait for us to catch up. We believe that providing the fastest and most reliable Internet to the communities we serve means committing to the present...Work at officeLong distance$19 - $21 per hour
Customer Sales & Service Representative A Customer Sales & Service Representative (CSSR) is responsible for establishing and maintaining profitable relationships with customers on behalf of Applied by taking personal and complete responsibility for each customer contact...Work experience placement$60k - $200k
World Insurance Associates (“World”) is a unique financial services organization with a global network of brokers and specialists who empower people to make informed decisions to improve their risk management outcomes, modernize their benefits programs, and help them achieve...Base plus commissionImmediate start$85k - $250k
Imagine Your Future with Us Since 1971, Paychex has been at the forefront of simplifying HR, payroll, and benefits for American businesses. Our digital HR technology and advisory solutions cater to the changing needs of employers and their employees. With our award-...Base plus commissionLocal area- A financial services company is looking for a Commercial Debt Counselor/Collector to manage and collect on delinquent business accounts. This role, which offers a base pay plus monthly bonuses based on performance, requires strong communication skills and a customer-focused...Remote work
$140k - $210k
Sales Executive - Packaging (REMOTE - Northeast based) This range is provided by Jobot. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $140,000.00/yr - $210,000.00/yr Job details Sales Executive - Packaging...Permanent employmentLocal areaRemote work- A healthcare company seeks a Pharmaceutical Sales Representative in New York to manage territory accounts and promote pharmaceutical products. Responsibilities include building relationships with health professionals and creating territory plans. Candidates should have ...Remote work
- Benefits: 401(k) Bonus based on performance Training & development Flexible schedule Paid time off Role: High-End Gutter Installation Sale Representative Who Are We? The Brothers that just do Gutters are a full-service rain gutter and gutter guard franchise...Flexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clm Resltion Rep IV, Hosp/Prv. Be the first to apply!
- benefits representative Rochester, NY
- work from home chat representative Rochester, NY
- quality control representative Rochester, NY
- community relations representative Rochester, NY
- payment posting representative Rochester, NY
- credentialing representative Rochester, NY
- loss control representative Rochester, NY
- operations representative Rochester, NY
- manufacturers representative Rochester, NY
- verification representative Rochester, NY




