Accounts Receivable Representative

About the role

The University of Chicago Physician’s Group (UCPG) is a component of the physician practice plan for the University of Chicago. The UCPG department provides billing services for medical services provided by University physicians and manages the accounts receivable and reporting processes for the Biological Sciences Division (BSD) departments.

Responsibilities

• Oversees the AR follow-up and denial resolution process with minimal direct oversight while also proactively reviewing current workflows for AR resolution with the intent to improve, implement, communicate and maintain an efficient AR resolution process.
• Identifies and resolves the systematic and/or operational root causes of denials and outstanding AR.
• Oversees and manages the AR follow-up work queues (WQ) and proposes both short and long-term enhancements that support business needs.
• Aids manager with maintaining payer scorecards, creating payer meeting agendas, and communicating issues to provider representatives.
• Works with the payers on escalated account resolution, identifies and submits high-complexity and other escalated payer projects, proactively reviews payer communication, initiates payer policy and rule change implementation, and proposes changes to front-end or back-end edits.
• Creates simple to moderately-complex reports that are necessary for payor projects using a variety of business tools.
• Communicates clearly and professionally with the other UCPG units, clinical departments, external vendors, and payers in order to build partnerships that result in denial resolution and prevention.
• Provides AR follow-up expertise to other UCPG and UCM business units as needed.
• Works closely with the Coding Education team to suggest opportunities for coder and provider training.
• Assists clinical departments in resolving escalated AR and denial issues.
• Works with Hospital Billing (HB) team on AR issues that cross between PB, HB, or SBO applications.
• Provide AR follow-up training to existing and new AR follow-up staff.
• Create denial Appeal, Reconsideration, and Medical Necessity letter templates and trains staff in effectively using these templates.
• Assists manager in developing and documenting policies and procedures.

Qualifications

• High School diploma required.
• Degree in business, finance, administration, or related field preferred.
• Background with physician revenue cycle specific AR follow-up and denial resolution required.
• Working knowledge using physician billing/revenue cycle software and electronic medical records systems required.
• Accomplished in diagnosis and CPT coding terminology required.
• Skillful in charge correction activities required.