Remote Risk Adjustment Coding Jobs in Warminster, PA

Responsibilities
This role requires a 3 month training period in office and must be within commuting distance to the King of Prussia, PA headquarters.
Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.
To learn more about IPM visit Physician Services - Independence Physician Management - UHS.
Position Overview
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.
Key Responsibilities include:

• 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

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

As an IPM employee you will be part of a first class organization offering:
A 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 much more!
Independence Shared Services is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee via email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of Independence Shared Services. No fee will be paid in the event the candidate is hired as a result of the referral or through other means.
About Universal Health Services
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World's Most Admired Companies by Fortune; and listed in Forbes ranking of America's Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com
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. We believe that diversity and inclusion among our teammates is critical to our success.
We believe that diversity and inclusion among our teammates is critical to our success.
Notice
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852- 3449