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BSD UCP - Revenue Cycle - Cash Application

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 the University and UCM department, patients, payers and other external entities to obtain the necessary information to process claims, collect cash and reduce AR.

Responsibilities:

• Review and resolve credit balances for various reasons, including, but not limited to refund request letters, coordination of benefit issues, charge corrections, overpayments, posting issues, and compliance projects.
• Review and correct potential payment posting issues identified by the follow up staff.
• Ensures all eligible payments received are posted correctly and timely. This includes manual lockbox and ACH payments.
• Perform patient and insurance inquiries for various revenue cycle activities; such as working denials, no activity follow-up accounts, registration related functions, eligibility inquires, 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 (PBLs), applying payments and adjustments to accounts.
• Responsible to make insurance follow-up phone calls to payers as well as update and process accounts/claims for submission to third party.
• Work with IT to resolve EDI file load errors and work with payers to resolve missing remit file issues.
• Pull back up needed for Insurance refund checks and mail to appropriate entities.
• 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.
• Responsible for following up with payors and/or vendor websites to obtain documentation not received with payment.
• Assist in tasks related to projects an 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.
• Research missing payments via invoices routed to Epic WQs by follow up staff, including, but not limited to:
• Reviewing and understanding the cash receivables process.
• Reviewing and understanding how payments are posted within the Epic System.
• Accessing various insurance portals to review payment details.
• Contacting various insurance vendors to locate/reissue checks sent to the incorrect location.
• Updating payment demographics with insurance vendors.

Competencies:

Ability to 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.

Ability to interact and communicate with clarity, tact and courtesy with patrons, patients, staff, faculty, students and others.

Ability to work with supervision to identify and describe work task priorities.

Ability to recognize and resolve or refer problems and conflicts.

Ability to negotiate and manage interpersonal communication effectively.