Independence Physician Management (IPM) · 6 hours ago
Claims Specialist
Wayne, PA
Full-time
Onsite
Mid Level
3+ years expIndependence Physician Management (IPM) is a subsidiary of UHS focused on developing and managing multi-specialty physician networks and urgent care clinics. The Claims Specialist is responsible for the accurate and timely resolution of professional billing claims, ensuring compliance with various edits and requirements, while working to improve processes and efficiency.
Hospital & Health Care
Responsibilities
This role requires a 3 month training period in office and must be within commuting distance to the King of Prussia, PA headquarters
The Claims Specialist is responsible for the accurate and timely resolution of professional billing claim and clearinghouse edits as well as payer rejections
This includes registration-based edits, claim requirement data edits (e.g. missing admission date), provider enrollment edits (e.g. missing NPI) and payer-specific edits
Meets or exceeds established performance targets (productivity and quality) established by the Billing Supervisor
Performs root cause analysis and identifies edit trends timely to minimize lag days, mitigate large volume claim submission delays and maximize opportunities to improve process and update the Practice Management System (PMS) logic as needed
Exercises good judgement in escalating identified root causes and edit trends to the Billing Supervisor, as needed, to ensure timely resolution and communication to stakeholders
Demonstrates the ability to be an effective team player
Upholds “best practices” in day-to-day processes and workflow standardization to drive maximum efficiencies across the team
Communicates effectively with IPM Coders to handle accurate and timely resolution of coding-based claim edits
Qualification
Required
High School Graduate/GED required
Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment
Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, claim submission requirements
Excellent organization skills and attention to detail
Service-oriented/customer-centric
Strong computer literacy skills including proficiency in Microsoft Office and mainframe billing software (e.g., Cerner, Epic, IDX)
Ability to handle data entry accurately in a high-paced environment
Ability to reconcile data and identify discrepancies
Research, and problem-solving ability
Results oriented with a proven track record of accomplishing tasks within a high-performing team environment
Preferred
Technical School/2 Years College/Associates Degree preferred
Understanding of the revenue cycle and how the various components work together preferred
Benefits
Competitive Compensation & Generous Paid Time Off
Excellent Medical, Dental, Vision and Prescription Drug Plans
401(K) with company match
Company
Independence Physician Management (IPM)
Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS.
1001-5000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase