Patient Accounts Receivable Rep I, Hybrid

University of Maryland Medical System; Linthicum (MD); On-site; USD 42,000 - 65,000; Full time

Job summary

University of Maryland Medical System is seeking an experienced billing/collections professional to support insurance verification, patient financial responsibility assessment, and account status updates to ensure timely reimbursement.

The role involves resolving denials, contacting payers and departments, and maintaining compliant collection procedures to reduce uncompensated care in a healthcare setting.

Qualifications

• 1 year work experience in general collections, accounts receivable oversight or customer service.
• Associates degree in healthcare; courses in Accounting, Finance, Business Administration and/or Healthcare Administration.

Responsibilities

• Works and maintains assigned receivables through work queues, age trial balance reports (ATB’s), and special projects to achieve department goals.
• Works with third party insurances to obtain maximum level of cash to reduce receivable.
• Reviews financial references, including guidelines for reimbursement, state and federal regulations, payer-specific reimbursement policies, procedures.
• Ensures correct processing of outstanding insurance claims by interpreting payer responses, requesting adjustments, submitting appeals and claim reconsiderations, evaluating patient financial responsibility, resolving denials and rejections.

Skills

Attention to detail

Effective communication

MS Excel

MS Word

PowerPoint

MS Access

SAS

Tableau

Discretion

Time management

Education

High School Diploma or GED

Associates degree in healthcare; courses in Accounting/Finance/Business Administration/Healthcare Administration

Tools

EPIC HB module

Job description

Job Requirements

Under general supervision this position supports the vision and mission for the University of Maryland Medical Systems, a multi-billion dollar, regional healthcare facility. Expectations include, but are not limited to, Insurance verification, evaluating financial responsibility of patients, updating accounts to a billable/collectible status, researching denials, claim rejections, and delays in reimbursement, utilizing all possible means to resolve accounts, which include contacting patients, insurance companies and other departments. Assists the department by organizing collection procedures and meeting performance goals while adhering to current laws and payer regulations and reducing uncompensated care.

Key Responsibilities

• Works and maintains assigned receivables through work queues, age trail balance reports (ATB’s), and special projects to achieve established department goals through resolution of outstanding account balances and reduction of uncompensated care.
• Works with third party insurances to obtain maximum level of cash to reduce receivable.
• Reviews financial references, including guidelines for reimbursement, state and federal regulations, payer-specific reimbursement policies, procedures.
• Ensures correct processing of outstanding insurance claims by: interpreting insurance payer responses, requesting account level adjustments, submitting appeals and claims reconsiderations, evaluating financial responsibility of patients, resolving insurance denials and claim rejections, performing insurance verification.

Knowledge, Skills And Abilities

• Concern for quality and ability to identify errors and implement corrections.
• Effective verbal and written communication skills are necessary in dealing with a variety of healthcare and finance professionals including senior management staff.
• Ability to work effectively in a matrix work environment and to manage multiple deadline-driven tasks and projects.
• Minimal knowledge or demonstrated ability to learn and understand HSCRC/CMS regulations, CPT (Current Procedural Terminology), and ICD-10 coding.
• Ability to operate a personal computer is required. Proficiency with the following applications is required: MS Excel, MS Word, and PowerPoint. MS Access, SAS, and Tableau is preferred.
• Ability to handle confidential issues with integrity and discretion.
• Ability to prioritize and manage work in a stressful environment.

Work Experience

Education

• High School Diploma or equivalent (GED)

Experience

• 1 year work experience in general collections, accounts receivable oversight or customer service

Licensures/Certifications

• NA

Work Experience

Education

• Associates degree in healthcare; courses in Accounting, Finance, Business Administration and/or Healthcare Administration

Experience

• Familiar with EPIC HB module
• Institutional and/or Professional Healthcare Collections
• Basic knowledge of insurance billing, collections, insurance or medical terminology; including CPT, ICD-10, HCPCS coding, EOB/EOP

Licensures/Certifications

• N/A