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BSD UCP - Revenue Cycle - Accounts Receivable Government

About the Department

The Biological Sciences Division (BSD) and the University of Chicago Medical Center (UCMC) are managed by a single Dean/Executive Vice President and comprises the largest unit of the University, accounting for 60% of its annual budget. All physician, hospital, and clinic services are managed through the Medical Center, which is a \$1.3 billion enterprise. The BSD includes the Pritzker School of Medicine, approximately 20 academic units, degree granting committees, and research centers and institutes. The BSD is located on the University\'s main campus in Hyde Park, ten minutes south of downtown Chicago. BSD\'s patient care operations are conducted primarily at the University of Chicago Hospital and clinics, which share the same campus. The University of Chicago Practice Plan (UCPP) is the central organization that supports the clinical activity of nearly 850 clinically active faculty practicing at the University of Chicago. These clinically active faculty collectively form the University of Chicago Physicians Group (UCPG). The University of Chicago Physicians\' 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 collection and reporting processes for the Biological Sciences Division (BSD) departments. Each physician is a faculty member and is based in a specified department in the BSD.

Job Information

Job Summary:

Responsible for assisting the revenue cycle team by performing one or more aspects of routine physician revenue cycle billing. Communicate and work with University and UCM departments, patients, payers and other external entities to obtain the necessary information to process claims, collect cash and reduce AR.

Responsibilities:

• Perform patient and insurance for various revenue cycle activities; such as working rejections, no activity follow-up accounts, registration-related functions, eligibility inquiries and other activities that contribute to AR/Account Resolution.
• Perform revenue cycle activities to resolve the account balance, such as resolving claim edits, rejections, resolve complex Provider Level adjustments (PLBs) credit balances, applying payments and adjustments to accounts.
• Responsible to make insurance follow-up phone calls to payers to resolve missing remit file issues.
• Work with IT to resolve EDI file load errors and work with payers to resolve missing remit file issues.
• Communicate with revenue cycle experts regarding the necessary medical records and clinical and/or billing information needed from the department to resolve accounts and escalate issues when appropriate to revenue cycle experts and/or manager.
• Complete daily payment batch reconciliation and create/update accounts within the billing system, including demographic and insurance changes or additions; and maintain documentation within the billing system for account activity.
• Assist in tasks related to projects and in the development, coordination and review of procedures.
• Correspond with internal and external constituencies to obtain appropriate documentation and/or information in an effort to resolve the account.

Competencies:

• Participate as a member of the staff in identifying priorities for the work unit and participate as a member of a work group or team.
• Interact and communicate with clarity, tact, and courtesy with patrons, patients, staff faculty, students, and others.
• Work with supervision to identify a d describe work task priorities.
• Recognize and resolve or refer problems and conflicts.
• Negotiate and manage interpersonal communication effectively.
• Handle multiple concurrent tasks in a competent and professional manner in a fast paced atmosphere.
• Solve problems independently with limited direction from the supervisor.

Additional Requirements

Education, Experience, or Certifications:

Education:

• High school diploma or GED required.

Experience:

• Background with physician billing experience required.
• Previous work with third party payor rules, procedures and policies in physician billing required.
• Background working with all government payors including but not limited to Medicare, Medicare Advantage Plans, Medicaid and Medicaid MCO\'s preferred.

Licenses and Certifications:

• Medical terminology certification preferred.
• CPT certification preferred.

Technical Knowledge or Skills:

Proficiency with Microsoft Office suite required.

Understand medical terminology/documentation and basic documentation such as help screens and departm