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Independence Physician Management (IPM) · 1 day ago

Accounts Receivable Specialist - REMOTE

United States

Full-time

Remote

Entry Level

1+ years exp

Independence Physician Management (IPM) is a subsidiary of UHS focused on managing multi-specialty physician networks and urgent care clinics. The Accounts Receivable Specialist is responsible for the accurate and timely follow-up of unpaid and underpaid claims, working to meet collection targets while minimizing write-offs.

Hospital & Health Care

Responsibilities

Accurate and timely follow-up on claims that have not received a response, have been denied, or have been under/over paid. Works with payer to determine reasons for denials. Corrects and reprocesses claims for payment in a timely manner. Proceeds with appeals process as needed. Performs eligibility and claim status follow-up inquiries utilizing outbound calls to the payer, web link tools and payer websites. Documents all actions taken on accounts worked according to the department policy to ensure clear understanding of encounter status

Identifies root causes and denial trends and makes recommendations to department leadership to prevent additional denials. Maintains a strong working knowledge of payer requirements and can research payer policies including LCD’s and NCD’s to help determine root cause for denial trends

As a last resort after exhausting all efforts, performs accurate write-offs (e.g. no authorization) following the identification of uncollectible accounts. Strictly adheres to IPM CBO write-off policies and procedures and utilizes proper adjustment aliases as defined in departmental job aides

Participates in regularly scheduled team meetings sharing denial trends specific to claim requirements to enhance front end claim edits to facilitate first pass resolution. Contributes ideas for workflows and approaches to A/R follow-up tasks to maximize opportunities for performance, process, and net revenue collections improvement

Meets established productivity metrics for the AR Department. Meets routinely with Supervisor to review productivity results and understands best practices and opportunities to create efficiencies in order to achieve maximum performance

Meets established quality metrics for the AR Department. Meets monthly with Supervisor to review quality results and collaborate on ways to improve scores. Upon receipt of monthly QR report, corrects any errors identified

Qualification

Healthcare revenue cycleCPT/ICD-10 codingClaim submission requirementsReimbursement guidelinesDenial reason codesMicrosoft OfficeOrganization skillsAttention to detailProblem-solving abilityTeam player

Required

High School Graduate/GED required

Experience (1-3 years minimum) working in healthcare revenue cycle

Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes

Excellent organization skills, attention to detail, research, and problem-solving ability

Results oriented with a proven track record of accomplishing tasks within a high-performing team environment

Service-oriented/customer-centric

Strong computer literacy skills including proficiency in Microsoft Office