Reimbursement Specialist & Denials Analyst

Universal Hospital Services Inc.; Richmond (CA); On-site; USD 52,000 - 70,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Medical, dental, vision plans

401(k) with company match

SoFi Student Loan Refinancing

Career development opportunities

Pet insurance

Job summary

Universal Health Services (UHS) is seeking a Reimbursement Specialist/Analyst for the Atlantic Region Central Billing Office. The role focuses on resolving accounts in Audit, Denial and Accounts Receivable systems and coordinating with payers, facilities, and HIM staff to ensure timely payments.

The position emphasizes accurate data entry, audit comprehension, and proactive communication to drive favorable outcomes and adherence to productivity targets across UHS hospitals.

Qualifications

• High school diploma or equivalent is required.
• 1-3 years healthcare experience preferred.
• Strong Microsoft Office skills (Excel, Word, Outlook) and excellent written and oral communication are required.

Responsibilities

• To ensure a complete and transparent reporting of outcomes resulting from subsequent follow up including audits.
• To effectively track, trend, and assure quality of all accounts by ensuring they are properly entered and tracked in all systems.
• Enter and follow up on audit accounts that are received by the CBO.
• Ability to comprehend audit requests and select appropriate audit type.
• Understanding of financial information for the account.
• As the audit progresses through the process, complete the updates and determine how to proceed with accounts that require action.
• Follow up with payers on all tasks that are due.
• Work with payers and facilities to obtain decision letters, and additional information as required.
• Document in patient account notes as indicated.
• Work with Appeals staff for resolution on denied accounts.
• Responsible for routing appeals relating to technical and clinical issues identified during the billing of claims, denial or receipt of audit. Works with HIM, vendors and facility clinicians to correct deficiencies in a timely manner Identify problem accounts and trends.
• Escalate as appropriate.
• Works with insurance companies to secure payment on account balances outstanding Properly documents the patient account with actions taken to resolve issue.
• Meet productivity standards and departmental goals and objectives.
• Other duties as assigned

Skills

Attention to detail

Multi-tasking

Written and verbal communication

Customer focus

Education

High school diploma or equivalent

Tools

Microsoft Excel

Microsoft Word

Outlook

Job description

Universal Health Services (UHS) is seeking a Reimbursement Specialist/Analyst for the Atlantic Region Central Billing Office. The role focuses on resolving accounts in Audit, Denial and Accounts Receivable systems and coordinating with payers, facilities, and HIM staff to ensure timely payments.

The position emphasizes accurate data entry, audit comprehension, and proactive communication to drive favorable outcomes and adherence to productivity targets across UHS hospitals.