Patient Accounts Receivable Representative I

Overview

Under general supervision this position supports the vision and mission for the University of Maryland Medical Systems, a multi-billion dollar, regional healthcare facility. Expectations include, but are not limited to, Insurance verification, evaluating financial responsibility of patients, updating accounts to a billable/collectible status, researching denials, claim rejections, and delays in reimbursement, utilizing all possible means to resolve accounts, which include contacting patients, insurance companies and other departments. Assists the department by organizing collection procedures and meeting performance goals while adhering to current laws and payer regulations and reducing uncompensated care.

Key Responsibilities

• Works and maintains assigned receivables through work queues, age trail balance reports (ATB’s), and special projects to achieve established department goals through resolution of outstanding account balances and reduction of uncompensated care.
• Works with third party insurances to obtain maximum level of cash to reduce receivable.
• Reviews financial references, including guidelines for reimbursement, state and federal regulations, payer-specific reimbursement policies, procedures.
• Ensures correct processing of outstanding insurance claims by: interpreting insurance payer responses, requesting account level adjustments, submitting appeals and claims reconsiderations, evaluating financial responsibility of patients, resolving insurance denials and claim rejections, performing insurance verification.

Knowledge, Skills and Abilities

• Concern for quality and ability to identify errors and implement corrections.
• Effective verbal and written communication skills are necessary in dealing with a variety of healthcare and finance professionals including senior management staff.
• Ability to work effectively in a matrix work environment and to manage multiple deadline-driven tasks and projects.
• Minimal knowledge or demonstrated ability to learn and understand HSCRC/CMS regulations, CPT (Current Procedural Terminology), and ICD-10 coding.
• Ability to operate a personal computer is required.  Proficiency with the following applications is required:  MS Excel, MS Word, and PowerPoint.  MS Access, SAS, and Tableau is preferred.
• Ability to handle confidential issues with integrity and discretion.
• Ability to prioritize and manage work in a stressful environment.

The University of Maryland Medical System (UMMS) is an academic private health system, focused on delivering compassionate, high quality care and putting discovery and innovation into practice at the bedside. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland. UMMS puts academic medicine within reach through primary and specialty care delivered at 11 hospitals, including the flagship University of Maryland Medical Center, the System's anchor institution in downtown Baltimore, as well as through a network of University of Maryland Urgent Care centers and more than 150 other locations in 13 counties. For more information, visit www.umms.org.

Qualifications

Education

• High School Diploma or equivalent (GED)
• Experience
• 1 year work experience in general collections, accounts receivable oversight or customer service

Preferred

Education

• Associates degree in healthcare; courses in Accounting, Finance, Business Administration and/or Healthcare Administration

Experience

• Familiar with  EPIC HB module
• Institutional and/or Professional Healthcare Collections 
• Basic knowledge of insurance billing, collections, insurance or medical  terminology; including CPT, ICD-10, HCPCS coding, EOB/EOP

All your information will be kept confidential according to EEO guidelines.

Compensation:

Pay Range: $19.65-$25.34

Other Compensation (if applicable):

Review the 2024-2025 UMMS Benefits Guide