Patient Accounts Receivable Representative I, Hybrid

University of Maryland Medical System Corporation; Linthicum (MD); On-site; USD 42,000 - 64,000; Full time

Job summary

The University of Maryland Medical System Corporation is seeking a detail-oriented patient accounts professional to support insurance verification, apply payments, and advance accounts toward billable status. You will research denials, communicate with patients and insurers, and help reduce uncompensated care.

With at least one year in general collections or accounts receivable, you will navigate CMS and payer regulations, use MS Excel and hospital billing tools, and contribute to a

Qualifications

• High School Diploma or equivalent (GED).
• 1 year work experience in general collections or accounts receivable oversight.
• Experience in customer service is acceptable.
• Knowledge of HSCRC/CMS regulations, CPT, ICD-10 coding is preferred.

Responsibilities

• Manage assigned receivables through work queues and ATB reports to reduce uncompensated care.
• Collaborate with third party insurances to maximize cash collection and reduce receivables.
• Review guidelines for reimbursement and payer policies to ensure compliant billing.
• Interpret payer responses, initiate adjustments, appeals, and resolve denials and delays.

Skills

MS Excel

Verbal & written communication

Attention to detail

Time management

Education

High School Diploma or GED

Associates degree in Healthcare or Accounting (preferred)

Tools

EPIC HB module

SAS

Tableau

MS Access

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.

Education

• High School Diploma or equivalent (GED)

Experience

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

Licensures/Certifications

• NA

Preferred Education

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

Preferred 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

Preferred Licensures/Certifications

• N/A