Offer summary

Qualifications:

High school diploma or equivalent required., Proficient in Microsoft Excel and Word., Strong analytical, organizational, and problem-solving skills., Ability to communicate professionally with various stakeholders..

Key responsabilities:

Manage outstanding worker’s compensation claims and collect payments.

Resolve billing issues and minimize uncollectable accounts.

Compile and submit appeals and disputes to appropriate payers.

Provide feedback to management on payer issues and denial trends.

Each year millions of workers are injured on the job and require medical attention. Since worker's compensation is an employee benefit governed by individual states, there are significant and varying rules and regulations involved in processing claims and obtaining reimbursements. Normal billing patterns in healthcare can't be applied to work comp because the nature of processing claims and the payer system is fundamentally different. This unique payor class lacks eligibility systems and invoicing remains a print and mail system burdened by "attachments". The collection process includes phone calls, high invoice submission rates and payment appeals. Finally, reimbursement rates differ by jurisdiction and providers don't know if payments are correct or not.UHS specializes in end to end management of worker's compensation claims for hospitals, surgery centers, and healthcare systems. We combine an in-depth knowledge of the work comp payor system with technology to create efficient methods of processing work comp claims from patient registration to cash application. Founded in 1997, UHS has managed over 2.1 million work comp patients, 5.7 million encounters, and $7.4 billion in work comp A/R for healthcare systems across the U.S.We take responsibility for processing work comp claims at patient registration. Our front end solution manages claim verifications and treatment authorizations as well as gathers important claim related information that will be needed to facilitate accurate billing and quick and accurate reimbursement. Healthcare providers bill claims in 837 format through clearinghouses to UHS. UHS handles the generation and distribution of invoices and performs all collection work. UHS ensures payments are accurate and cash posting is automated with 835 ERAs.Results include better collection yields, fewer unpaid accounts, lower A/R, process automation and lower processing costs.Talk to us about improving your work comp revenue cycle.

Job description

Job Type

Full-time

Description

Job Grade: 4

Purpose of job:

The Reimbursement Specialist is responsible for managing outstanding worker’s compensation claims by collecting payments, resolving billing issues, and minimizing the number of uncollectable accounts. The ideal candidate will be results-driven and able to focus on key performance metrics to ensure quality and efficiency standards set forth by the company are met.

Main Duties

Contact insurance payers, employers, or responsible parties in an effort to collect on outstanding accounts receivables.
Identify and resolve improper payments, incorrect denials, billing errors and payer discrepancies.
Compile accurate and effective appeals and disputes to the appropriate payers and state divisions.
Ensure individual and department goals are met, specifically:

- Reduce the number of past due accounts through timely follow-up;

- Reduce the number of past due accounts through escalation and claim resolution;

- Increase cash performance through effective and persuasive collection attempts;

- Reduce the number of days in AR for uncollectable accounts

Research, compile, maintain and manage quality data related to collection efforts.
Provide feedback to management regarding payer issues, underpayments and denial trends.

Requirements

Qualifications:

High school diploma or equivalent
General Office Knowledge (Microsoft Excel and Word)
Proper phone and email etiquette

Knowledge, Skills and Abilities:

Ability to review, analyze and interpret payor reimbursements, billing guidelines, and state or federal regulations.
Detail oriented, with strong analytical, organizational and problem solving skills.
Communicate professionally and effectively with employers, insurance payers, and UHS customers.
Demonstrates a strong work ethic by managing time effectively and completing all tasks as assigned.
Ability to balance productivity with a high-quality level of work standards.
Adaptable with the ability to learn and apply knowledge of new programs and procedures quickly.
Maintain confidentiality and appropriate HIPAA compliance guidelines.

Required profile