Remote Medical Claim Auditor Jobs in Reno, NV (NOW HIRING)

Responsibilities
Remote opportunity.
This role requires a 3 month training period in office if you live within commuting distance to the King of Prussia, PA headquarters.
Independence Physician Management (IPM) was formed in 2012 as the physician services unit. IPM develops and manages multi-specialty physician networks and urgent care clinics within the Acute Care and Behavioral Health Divisions. A subsidiary of UHS, IPM operates in 13 markets across 7 states - and counting. We help doctors manage their practices and clinical procedures so they can concentrate on caring for their patients.
To learn more about IPM visit Physician Services - Independence Physician Management - UHS.
Successful candidate must live in one of these locations:

• Pennsylvania
• Florida
• Texas
• Nevada

The Accounts Receivable Specialist is responsible for the accurate and timely follow-up of unpaid and underpaid claims by assigned payer/s and defined aging criteria to meet or exceed collection targets and minimize write-offs. Researches claim denials by assigned payer/s to determine reasons for denials correcting and reprocessing claims for payment in a timely manner. Meets or exceeds the department's established performance targets (productivity and quality). Initiates and follows-up on appeals. Exercises good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedites the reprocessing of claims and maximizes opportunities to enhance front end claim edits to facilitate first pass resolution. Identifies uncollectible accounts and performs accurate and timely write-offs (e.g. no authorization) adhering to IPM CBO policy guidelines. Demonstrates the ability to be an effective team player. Upholds "best practices" in day-to-day processes and workflow standardization to drive maximum efficiencies across the team.
Job Responsibilities:

• Accurate and timely follow-up on claims that have not received a response, have been denied, or have been under/over paid. Works with payer to determine reasons for denials. Corrects and reprocesses claims for payment in a timely manner. Proceeds with appeals process as needed. Performs eligibility and claim status follow-up inquiries utilizing outbound calls to the payer, web link tools and payer websites. Documents all actions taken on accounts worked according to the department policy to ensure clear understanding of encounter status
• Identifies root causes and denial trends and makes recommendations to department leadership to prevent additional denials. Maintains a strong working knowledge of payer requirements and can research payer policies including LCD's and NCD's to help determine root cause for denial trends.
• As a last resort after exhausting all efforts, performs accurate write-offs (e.g. no authorization) following the identification of uncollectible accounts. Strictly adheres to IPM CBO write-off policies and procedures and utilizes proper adjustment aliases as defined in departmental job aides.
• Participates in regularly scheduled team meetings sharing denial trends specific to claim requirements to enhance front end claim edits to facilitate first pass resolution. Contributes ideas for workflows and approaches to A/R follow-up tasks to maximize opportunities for performance, process, and net revenue collections improvement.
• Meets established productivity metrics for the AR Department. Meets routinely with Supervisor to review productivity results and understands best practices and opportunities to create efficiencies in order to achieve maximum performance.
• Meets established quality metrics for the AR Department. Meets monthly with Supervisor to review quality results and collaborate on ways to improve scores. Upon receipt of monthly QR report, corrects any errors identified

Benefit & Rewards Highlights

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• Career development opportunities within UHS and its 300+ Subsidiaries!
• Pet Insurance
• More information is available on our Benefits Guest Website: benefits.uhsguest.com

Qualifications
High School Graduate/GED required. Technical School/2 Years College/Associates Degree preferred.

• Work experience: Experience (1-3 years minimum) working in healthcare revenue cycle
• Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes
• Understanding of the revenue cycle and how the various components work together preferred
• Excellent organization skills, attention to detail, research, and problem-solving ability. Results oriented with a proven track record of accomplishing tasks within a high-performing team environment. Service-oriented/customer-centric. Strong computer literacy skills including proficiency in Microsoft Office

EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
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