Patient Accounting Representative II, Pat Fin Svc-Billing-Follow-Up, Full Time, First Shift

Revenue Cycle Account Receivable Manager

Managing Revenue Cycle accounts receivable, following standard Operating Departmental Procedures to ensure prompt payment of payer and patient payments. Responsible for collaborating with other departments, or third parties, to drive payer and patient collections.

Responsibilities

Revenue Cycle Functions:

• Communicates directly with payers to follow up on outstanding claims and achieve timely reimbursement. This may include obtaining claim status, submitting reconsiderations, or submitting appeals.
• Monitors and reviews denial reason codes to identify root causes; works with payer contracting, other areas of the revenue cycle, and payer representatives, if necessary to resolve issues
• Analyzes data to track collection efforts, identify trends, and provide team with updates and ideas for improvement
• Monitors payer files for accuracy, ensures payer documentation is completed by follow-up staff, and assists in updating files with pertinent information as necessary
• Assists other follow-up staff in identifying high-risk accounts and prioritizing follow-up efforts
• Helps to work and resolve accounts from other staff members' workloads to prevent backlogs and fills in as needed for absent staff
• Maintains superior understanding of claims management, third-party payer guidelines, state and federal regulations, and all other functions of the job; educates and trains other follow-up staff as needed
• Maintains compliance with HIPAA guidelines and ensures staff maintain discrepancy when handling patient information
• Works independently to resolve claims issues
• Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and tracking progress
• Offers suggestions to improve individual and team productivity
• Maintains a quality review score of 90% or greater on department quality reviews
• Assists supervisor with identifying departmental areas in need of improvements

Self-Development:

• Attends 1 or more UC Health training and development courses per year
• Other duties as assigned

Productivity:

• Maintains 100% or greater each week on department productivity scoring and takes responsibility for individual productivity standards

Quality:

• Other duties as assigned

Qualifications

Education

Minimum Required: High School Diploma or GED. Preferred: Associate degree.

Experience

Minimum Required: 3 5 years of relevant experience in Revenue Cycle and/or Epic Revenue Cycle applications.

UC Health is an EEO employer.