Insurance Collection Rep III - Strong West

Rochester, NY

Responsibilities

Position Summary:

With minimum direction, serves as the lead contact at the department level for the following functions: billing, coding compliance and charge entry. Trains new employees and monitors quality and quantity of work performed in the department.

Typical Duties:

  1. Serves as department expert and focal point for answering questions for the following functions: billing, coding compliance, charge entry, and for solving problems regarding difficult or unusual situations.

  2. Responsible for resolving claims that are unbilled due to charge review and claim edits. In addition, is responsible for assisting billing staff for claims with no response from the payor and denied by 3rd party payors due to insurance listing on claims, billing/coding issues (i.e. modifiers, bundling and CPT and diagnosis coding).

  3. Through detailed knowledge of third-party billing/coding requirements, payor and governmental contracts, determine the most effective method to evaluate root cause of hold or edit and bring unbilled visit to complete resolution (claim billed/accepted by payor). Also, completely resolve claims in No Activity and Follow-up workqueues.

  4. Assists in the development of goals and objectives for the area. Helps write new procedures and training materials; updates existing procedures as needed.

  5. Performs quality assurance monitoring for all activities performed/completed in the areas of responsibility. Through research of outstanding claim holds, edits and denials, document areas of opportunities to prevent future billing delays or non-payments. Present documentation to Radiation Oncology Department Management.

  6. Identify and clarify issues that require management intervention. Research and prepare problem accounts for insurance representatives/supervisor to review for claims which have denied inappropriately based on known billing and coding rules.

  7. Serves as liaison within the department with the Patient Accounts Office (PAO) and the United Business Office (UBO). Assist with documentation requests and claim denial questions from PAO.

  8. May perform other duties as assigned.

Qualifications:

Associate’s degree in business field and 4-5 years’ experience in hospital or professional billing, accounting and/or coding; or an equivalent combination of education and experience.

Preferred Qualifications:

Exceptional verbal and written communication skills with demonstrated leadership and customer service skills. Knowledge of Microsoft Office programs (Excel, Word, Email.) Knowledge of ePARC.

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.

How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

Pay Range

Pay Range: $ 19.37 - $ 27.12 Hourly

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

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Location: Strong Memorial Hospital
Full/Part Time: Full-Time
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