UNM Medical Group
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Accounts Receivable 2
at UNM Medical Group
Commensurate with experience
# of Openings:
Position Class Code/Title: B2001 / Accounts Receivable 2
OPEN UNTIL FILLED
COVER LETTER REQUIRED
UNM Medical Group, Inc. (UNMMG) is the practice plan organization for physicians and other medical providers associated with the UNM Health Sciences Center. UNM Medical Group, Inc. is a New Mexico non-profit corporation and is an equal opportunity employer. UNMMG offers a competitive salary and an attractive benefit package which includes medical, dental, vision, and life insurance as well as tuition assistance, paid leave and 403b retirement for benefits eligible employees.
This position will work with a team of other staff to reconcile IDX postings from the billing system to the financial receipts in a timely manner. In addition, this person will work credit balances for patients and post denials from correspondence and/or bank scannings. In order to properly work all receipts, at times research is needed to determine the payer, find the details of the payment or determine the correct codes to use.
The following statements are intended to describe, in broad terms, the general functions and responsibility levels characteristic of positions assigned to this classification. They should not be viewed as an exhaustive list of the specific duties and prerequisites applicable to individual positions that have been so classified.
Under direct supervision, performs a variety of routine to complex day-to-day operations related to posting of Electronic Data Interchange (EDI) 835 files which requires independent research, investigation, and problem resolution.
Duties and Responsibilities
- Processes and researches electronic data interchange (EDI) reimbursements from various payers; processes EDI payments, contractual allowances, and related transactions on patient invoices, as required.
- Performs daily and monthly reconciliations to the general ledger, to include reclassifications; receives and balances documents of deposits received.
- Researches and analyzes third-party payer remittance documentation in order to reconcile payments to remittance advices; reconciles and applies changes and corrections to patient invoices and accounts.
- Follows up directly with third-party payers and or patients, either by telephone or in writing, to resolve payment posting issues.
- Prepares routine patient and third party payer refund request forms with the required documentation.
- Ensures strict confidentiality of patient medical and financial records, in compliance with federal and state patient privacy legislation.
- Interfaces with other departmental representatives in the resolution of identified problems and issues.
- Participates in the development and execution of departmental goals and objectives.
- May provide task-specific support and guidance to others in the department, as appropriate.
- Performs miscellaneous job-related duties as assigned.
Minimum Job Requirements
High school diploma or GED with at least 3 years of experience that is directly related to the duties and responsibilities specific. Verification of education and licensure (if applicable) will be required if selected for hire.
Knowledge, Skills and Abilities Required
- General understanding of insurance company procedures to include workman’s compensation and third party payers.
- Proficient in number pad entry.
- Knowledge of medical terminology, ICD-9, and CPT coding.
- Knowledge of IDX or supplementary billing systems, payment and adjustment processes.
- Knowledge of Windows-based software applications. (Eg: Word, Excel)
- Strong organizational and time-management skills.
Conditions of Employment
- Must be employment eligible as verified by the U.S. Dept. of Health and Human Services Office of Inspector General (OIG) and the Government Services Administration (GSA).
- Must pass a pre-employment criminal background check.
- Fingerprinting, and subsequent clearance, is required.
- Must provide proof of varicella & MMR immunity or obtain vaccinations within 90 days of employment.
- Must obtain annual influenza vaccination.
- If this position is assigned to a clinical area, successful candidate will be required to complete a pre-placement medical evaluation/health screen. Required N-95 mask fitting, testing, vaccinations to include annual TST, Tdap, and Hepatitis B will be determined based on location and nature of position.
Working Conditions and Physical Effort
- Work is normally performed in a typical interior/office work environment.
- No or very limited exposure to physical risk.
- Moderate physical activity. Requires handling of average-weight objects up to 25 pounds or standing and/or walking for more than four (4) hours per day.