Professional Fee AR Specialist
Job Requirements
Company Description
The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the states future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the Systems anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit www.umms.org.
Job Description
I. General Summary Under general supervision, evaluates financial responsibility of patients, updates accounts to a billable/collectible status, research all possible means to resolve accounts, contacts patients, insurance companies and other departments regarding financial reimbursement. Organizes collection procedures in accordance with current laws, serves as appropriator of patient accounts and prioritizes multiple collection tasks with the main objective to reduce uncompensated care. II. Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. 1. Responsible for defined accounts receivable. Accountable for reduction of Accounts Receivable equal to goals set by senior management. 2. Works with third party insurance and payer contracting department to obtain maximum level of cash to reduce receivable. Follows up with insurers to recover inaccurate payments. 3. Reviews accounts to ensure accuracy of billing/charging utilizing knowledge of pre-certification /prior authorization procedures to validate account status. Resolves any problems with billing or handling of accounts. 4. Handles patient concerns with professionalism and excellent customer service skills. Relays any patient suggestions and complaints to immediate supervisor for consideration. Provides answers for patients questions in a reasonable response time. 5. Follows departmental guidelines for handling delinquent accounts receivable. A. Utilizes compassionate care program appropriately. B. Researches all avenues of funding for patients who exhibit financial need. C. Works with the Medical Assistance Eligibility team to refer patients through the Medical Assistance process. 6. Gathers and records data for the purpose of enhancing and perfecting collection procedures. A. Shares information with the team to improve the integrity of data. B. Shares information with administrator to solve existing problems with systems or data and effectively promotes avoidance of future problems. 7. Effectively updates and/or views data in all accessible systems. 8. Assists supervisor with new staff training 9. Accommodates all visitors with accurate information and professionalism. 10. Performs appeals process when appropriate.
Qualifications
III. Education and Experience 1. High School Diploma or equivalent (GED) is required. Associates Degree preferred. Three years Professional Fee billing experience required. IV. Knowledge, Skills and Abilities 1. Knowledge of collection laws, medical coding (CPT & ICD-9/10) and third party billing guidelines including timely filing limitations and Medical terminology preferred. 2. Develops knowledge of current collection laws. 3. Demonstrated ability to perform mathematical calculations. 4. Demonstrated proactive problem-solving skills. Ability to interpret data and related information and discern trends, tendencies as well as determines appropriate course of action. 5. Demonstrated ability to use PC applications such as spreadsheets and word processing 6. Highly effective oral and written communication skills are necessary in order to communicate effectively with clinicians, patients and insurance companies. 7. Ability to meet quality performance standards. 8. Ability to maintain a culture of excellent customer service, open and friendly staff relations with associates of all levels.
Additional Information
All your information will be kept confidential according to EEO guidelines. Compensation: Like many employers, UMMS is being targeted by cybercriminals impersonating our recruiters and offering fake job opportunities. We will never ask for banking details, personal identification, or payment via email or text. If you suspect fraud, please contact us at careers@umms.edu.
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