Account Receivable Representative (Government)

Department BSD UCP - Revenue Cycle - Accounts Receivable Government About The Department The Biological Sciences Division (BSD) and the University of Chicago Medical Center (UCMC) are managed by a single Dean/Executive Vice President and comprises the largest unit of the University, accounting for 60% of its annual budget. All physician, hospital, and clinic services are managed through the Medical Center, which is a $1.3 billion enterprise. The BSD includes the Pritzker School of Medicine, approximately 20 academic units, degree granting committees, and research centers and institutes. The BSD is located on the University's main campus in Hyde Park, ten minutes south of downtown Chicago. BSD’s patient care operations are conducted primarily at the University of Chicago Hospital and clinics, which share the same campus. The University of Chicago Practice Plan (UCPP) is the central organization that supports the clinical activity of nearly 850 clinically active faculty practicing at the University of Chicago. These clinically active faculty collectively form the University of Chicago Physicians Group (UCPG). The UCPG department provides billing services for medical services provided by University physicians and manages the accounts receivable collection and reporting processes for the Biological Sciences Division (BSD) departments. Each physician is a faculty member and is based in a specified department in the BSD. Job Summary Responsible for assisting the revenue cycle team by performing one or more aspects of routine physician revenue cycle billing. Communicate and work with University and UCM departments, patients, payers and other external entities to obtain the necessary information to process claims, collect cash and reduce AR. Responsibilities Perform patient and insurance for various revenue cycle activities such as working rejections, no activity follow up accounts, registration-related functions, eligibility inquiries and other activities that contribute to AR/Account Resolution. Perform revenue cycle activities to resolve the account balance, such as resolving claim edits, rejections, resolve complex Provider Level adjustments (PLBs), credit balances, applying payments and adjustments to accounts. Make insurance follow-up phone calls to payers to resolve missing remit file issues. Work with IT to resolve EDI file load errors and work with payers to resolve missing remit file issues. Communicate with revenue cycle experts regarding the necessary medical records and billing information needed from the department to resolve accounts and escalating issues when appropriate. Complete daily payment batch reconciliation and create/update accounts within the billing system; including demographic and insurance changes or additions; also maintain documentation within the billing system for account activity. Assist in tasks related to projects and in the development, coordination and review of procedures. Correspond with internal and external constituencies to obtain appropriate documentation and/or information in an effort to resolve the account. Competencies Ability to participate as a member of the staff in identifying priorities for the work unit and participate as a member of a work group or team. Ability to interact and communicate with clarity, tact, and courtesy with patrons, patients, staff faculty, students, and others. Ability to work with supervision to identify and describe work task priorities. Ability to recognize and resolve or refer problems and conflicts. Ability to negotiate and manage interpersonal communication effectively. Ability to understand medical terminology/documentation and basic documentation such as help screens and departmental handouts. Ability to handle multiple concurrent tasks in a competent and professional manner in a fast‑paced atmosphere. Ability to solve problems independently with limited direction from the supervisor. Education, Experience, or Certifications Education High School Diploma or GED required. Experience Previous experience with physician billing required. Previous experience using electronic medical records (EMR) systems preferred. Previous experience with diagnosis and CPT coding terminology required. Previous experience working with third‑party payor rules, procedures and policies in physician billing required. Previous Epic EMR experience preferred. Previous experience working all Government Payors including but not limited to Medicare, Medicare Advantage Plans, Medicaid and Medicaid MCOs preferred. Experience with Physician AR follow‑up required. Experience working with UB04 and/or CMS 1500 required. Licenses And Certifications Medical terminology certification preferred. CPT certification preferred. Technical Knowledge Or Skills Proficiency with Microsoft Office suite required. PC experience which includes spreadsheets, word processing, presentations, and databases. Interpret documents such as encounter forms, medical records, physician documentation, lab reports, dictated reports, operating instructions, and policy/procedure manuals. Thorough working knowledge of federal and state regulations regarding reimbursement. Comprehensive knowledge of third‑party payer rules, procedures, and policies in all areas of billing and collection. Working knowledge of healthcare billing and clinical systems. Working Conditions And Physical Requirements Remote; occasional on‑site presence for team meetings and trainings, requiring someone to be located in or around the Illinois area to travel as needed. Pay Range $22.17 - $32.47 hourly Required Documents Resume Cover Letter Benefit Eligibility Yes. The University of Chicago offers a wide range of benefits programs and resources for eligible employees, including health, retirement, and paid time off. Equal Employment Opportunity Statement The University of Chicago is an equal‑opportunity employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender, gender identity, or expression, national or ethnic origin, shared ancestry, age, status as an individual with a disability, military or veteran status, genetic information, or other protected classes under the law. For additional information please see the University's Notice of Nondiscrimination. Job seekers in need of a reasonable accommodation to complete the application process should call the University’s application hotline or submit a request through the Applicant Inquiry Form. #J-18808-Ljbffr University of Chicago