University Of Rochester Rochester , NY 14618
Posted 6 days ago
Search in...
No results to display
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Title
Actions
Home
NavBar
Help
Sign Out
Job Description
More Actions
Previous Job
Job Title
Clm Resltion Rep III, Hosp/Prv- Remote/Hybrid Opportunity
Next Job
Apply for Job
When you are ready to apply, registering only takes a minute. Your online account allows you to upload your resume or CV, apply for jobs and access our online career tools.
For general questions about the online application process, please call Ask-URHR at (585) 275-8747 or email ask-urhr@rochester.edu (Monday- Friday, 8:00 am to 5:00 pm).
EOE Minorities / Females / Protected Veterans / Disabled
Requests for accommodations should be directed to (585) 275-4995.
EEO Notices
FAQs for Applicants
Job ID
253781
Location
Strong Memorial Hospital
Full/Part Time
Full-Time
Regular/Temporary
Regular
Add to My Favorite Jobs
Email this Job
Opening
Full Time 40 hours Range URC 205 Patient Financial Services
Responsibilities
Location:
Rochester Tech Park (RTP), Gates, NY- Remote options available after in-person training. Occasional onsite meetings / work at RTP are required. Remote location must be within 2 hours of RTP and within New York State.
Position Summary:
With latitude for initiative and independent judgment within department guidelines, the position is responsible for managing inpatient/outpatient accounts from the beginning of the billing period through the accurate resolution of the account. Revenue collection activities focus on an assigned payer billed at the primary level. Activities performed will focus on resolving balances on aged insurance accounts which have not been collected through routine billing and collection activities, ensuring the visit balances are set up on the accounts receivable at expected reimbursement, and determining and completing the collection process that will result in payment. Makes independent decisions as to the processes necessary to collect denied insurance claims and resolve billing issues. Maintain a detailed knowledge of billing requirements and regulations to ensure that the process conforms to federal and state regulations. The Claim Resolution Rep III will represent the department and Strong Memorial Hospital (SMH) in a professional manner, protecting confidentiality of patient information at all times.
Supervision and Direction Exercised:
The Claim Resolution Rep III is responsible for self-monitoring performance on assigned tasks, following standard procedures and as directed by the Supervisor, Revenue Cycle Management.
Machines and Equipment Used:
Standard office equipment, including but not limited to: telephone, photocopy machine, adding machine, personal computer (for claims inquiry and entry software) fax/scanner, Flowcast billing application, Microsoft Word, Excel, Access, Email, Emdeon (Fidelis Medicaid Managed Care and Medicare Part B) clearinghouse software, third party claims systems (ePaces, Omnipro) and various payer web sites.
Typical Duties:
30% Complete follow up activities on unpaid or under-paid accounts by contacting payer representatives or utilizing online systems with insurance companies and other third party payers to obtain payments, research and resubmit rejected claims to primary payers, obtain and verify insurance information.
25% Work weekly, bi-weekly and monthly reports and Work Lists via calculating and processing transactions such as payer to payer transfers, contractual adjustments, verify that the insurance levels and proration are set up correctly on the system.
20% Utilize a thorough knowledge of inpatient/outpatient billing policies and procedures for primary levels of third-party insurance; prepare log and related management reports when needed, price claims to establish the expected reimbursement on the revenue cycle system.
20% Identify and clarify issues, payment variances and/or trends that require management intervention; share with Supervisor and or Manager. Assist Supervisor with Medicare and Medicaid credit balance audits, and third-party payor audits
Coordinate responses and resolution to Medicaid and Medicare credit balances
Review all accounts on the Medicaid and Medicare credit balance report:
Request insurance adjustments or retractions
Prepare requests for insurance and patient refunds
5% Research and respond to third party correspondence, receive phone calls, explain policies and procedures involving routine and non-routine situations. Assist other areas with patient related questions. Communicate with other Hospital departments and with government and commercial insurance companies.
Expectations:
Qualifications:
Requires: Associate's degree in Business Administration and 2 years of hospital patient accounting or consumer collections experience; or an equivalent combination of education and experience.
Note: This document describes typical duties and responsibilities and is not intended to limit managers from assigning other work as required.
The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University's mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled
Pay Range
Pay Range: $19.62 - $26.49 Hourly
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
University Of Rochester