UNM Medical Group
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Accounts Receivable Tech 3
at UNM Medical Group
UNM Cancer Center - Revenue Cycle
$16.15 minimum to $20.19 midpoint, hourly
# of Openings:
Job Code/Title: B3001/ Accounts Receivable Tech 3
FLSA: Non- Exempt
OPEN UNTIL FILLED
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.
The Accounts Receivable Tech 3 analyzes and investigates payments made by all insurance companies and patients to resolve any billing problems and/or any issues. Assists with month end closing to help balance and post payments as needed.
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 general supervision, performs a variety of complex functions to resolve involved billing problems and issues, and maintains appropriate ledgers. Performs complex analyses of patient accounts, patient payments, and remittance advices from third party payers, posts complex account adjustments, transfers, and other actions. Initiates correspondence to responsible parties or third party payers, as applicable. Provides day-to-day guidance and mentorship to lower level staff, as appropriate.
Duties and Responsibilities
- Analyzes and investigates reimbursements or refund requests from third party payers, such as Medicare, Tricare, Medicaid, Salud, HMO’s, and other payers, to determine if contracted amount has been allowed; researches and analyzes third party payer remittance documentation to determine priority of payment and application of adjustments.Uses MPV Contract Management to assure proper refund/reimbursement.
- Compiles and submits appeals and monitors for proper reimbursement.
- 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 in order to resolve complex credit balances.
- Follows up directly with third-party payers and or patients, either by telephone or in writing, to resolve payment posting issues.
- 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 related to the duties and responsibilities specified. Verification of education and licensure (if applicable) will be required if selected for hire.
Knowledge, Skills and Abilities Required
- Ability to identify and resolve reimbursement and credit balance issues related to all medical insurance payer groups.
- Knowledge of rules governing primary/secondary responsibility and patient responsibility after third party payments and denied services.
- Knowledge of IDX related screens and functions, to include the various reports currently used to identify and resolve credit balances.
- Thorough understanding of insurance company procedures to include workman’s compensation and third party payers.
- Proficient in number pad entry. (Also included in AR1, and AR2)
- Knowledge of state and federal patient privacy of information legislation.
- 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.
- Ability to calculate numbers, determine incorrect entries, and post corrections to records.
- Knowledge of general accounting principles.
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.