Patient Accounting Representative II, PBO Follow Up, Full Time

Patient Accounting Representative II, PBO Follow Up, Full Time

Managing Revenue Cycle accounts receivable, following standard Operating Departmental Procedures to ensure prompt payment of payer and patient payments. Responsible for collaborating with other departments, or third parties, to drive payer and patient collections.

Revenue Cycle Functions:

Communicates directly with payers to follow up on outstanding claims and achieve timely reimbursement. This may include obtaining claim status, submitting reconsiderations, or submitting appeals.

Monitors and reviews denial reason codes to identify root causes; works with payer contracting, other areas of the revenue cycle, and payer representatives, if necessary to resolve issues

Analyzes data to track collection efforts, identify trends, and provide team with updates and ideas for improvement

Monitors payer files for accuracy, ensures payer documentation is completed by follow-up staff, and assists in updating files with pertinent information as necessary

Assists other follow-up staff in identifying high-risk accounts and prioritizing follow-up efforts

Helps to work and resolve accounts from other staff members’ workloads to prevent backlogs and fills in as needed for absent staff

Maintains superior understanding of claims management, third-party payer guidelines, state and federal regulations, and all other functions of the job; educates and trains other follow-up staff as needed

Maintains compliance with HIPAA guidelines and ensures staff maintain discrepancy when handling patient information

Works independently to resolve claims issues

Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and tracking progress

Offers suggestions to improve individual and team productivity

Maintains a quality review score of 90% or greater on department quality reviews

Assists supervisor with identifying departmental areas in need of improvements

Self-Development:

Attends 1 or more UC Health training and development courses per year

Other duties as assigned

Productivity:

Maintains 100% or greater each week on department productivity scoring and takes responsibility for individual productivity standards

Quality

Other duties as assigned

Education

Minimum Required: High School Diploma or GED. Preferred: Associate degree.

Experience

Minimum Required: 3 – 5 years of relevant experience in Revenue Cycle and/or Epic Revenue Cycle applications.

Preferred:

• Minimum 12 -24 months experience in Professional, Medical Billing.

• Experience with EPIC PB Resolute billing system, Claim Clearinghouse and Payer Websites (I.e., Waystar, Availity)

Skills for Success:

• Ability to self-manage and work independently in a remote environment, using electronic applications, phone communication, and written documentation.
• Ability to manage a daily work schedule and accurately report time and attendance according to the assigned schedule. Must also be available for limited on-site attendance at the UCMC Business Center when required.
• Demonstrate UCH PRIIDE Values through professional and respectful communication with internal and external customers.
• Ability to prioritize, organize, and coordinate workload effectively to meet daily responsibilities and deadlines.
• Demonstrate strong analytical, problem-solving, and decision-making skills, including the ability to exercise sound judgment and make independent decisions within established policies and procedures.
• Ability to understand, follow, and apply written procedures, and other guidance to daily work.
• Ability to adapt to frequent changes in payer rules, requirements, and workflows while remaining flexible, professional, and responsive.
• Maintain a high level of accuracy and attention to detail, including thorough, concise, and complete documentation.
• Ability to communicate proactively in a remote work environment, including asking questions, responding to requests, and escalating issues through established communication channels when appropriate.
• Demonstrate a willingness to learn new processes and adjust established work practices when needed.

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.

As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.

UC Health is committed to providing an inclusive, equitable and diverse place of employment.