UNM Medical Group, Inc. · 1 day ago

Account Operations Tech 3

Albuquerque, NM

Full-time

Remote

Mid, Senior Level

$40K/yr - $50K/yr

5+ years exp

Maximize your interview chances

Hospital & Health Care

Insider Connection @UNM Medical Group, Inc.

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

Analyzes and investigates reimbursements from third party payors, such as Medicare, Champus, Medicaid, Salud, HMO's, and other payors, to determine if contracted amount has been allowed; researches and analyzes third party payor remittance documentation to determine priority of payment and application of adjustments.

Reconciles and applies changes to patient invoices and account to correct account issues; initiates inquiries, either by phone or in writing, to third party payors, and/or patients to resolve reimbursement and credit balance issues.

Responds to requests from third party payors and/or patients regarding reimbursement problems and issues.

Interacts with and advises internal staff regarding billing and documentation policies, procedures, and serves as liaison with other department representatives to resolve reimbursement and/or credit balance issues.

Prepares adjustment and refund request forms.

Collects, analyzes, and summarizes data for preparation of statistical reports; creates and maintains specified data files and logs, maintains computerized systems for collection and tracking of data, and assists in the preparation of reports.

Ensures strict confidentiality of patient medical and financial records, in compliance with federal and state patient privacy legislation.

Assists in departmental problem solving, project planning, and the development and execution of departmental goals and objectives.

May provide task-specific support and guidance to other techs, as appropriate.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Billing analysisPatient account managementThird party payor knowledgeData analysisStatistical reportingConfidentiality compliance

Required

High school diploma or GED with at least 5 years of experience that is directly related to the duties and responsibilities specified.

Completed degree from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis.

Verification of education and licensure (if applicable) will be required if selected for hire.