Revenue Cycle Operations Specialist

2 weeks ago

Albuquerque, New Mexico, United States UNM Medical Group, Inc. Full time
Job Overview

UNM Medical Group, Inc. is seeking a Revenue Cycle Operations Specialist to enhance our Revenue Cycle department. This is a full-time position with day shift hours.

Compensation: Minimum $38,916 - Midpoint $48,651*

*Salary is contingent upon years of relevant experience.

*Salary is based on a full-time equivalent (1.0 FTE) or 40 hours per week. Positions with fewer hours will be prorated accordingly.

Position Summary

Under general supervision, the Revenue Cycle Operations Specialist will engage in a variety of intricate tasks to address complex billing challenges and maintain accurate ledgers. This role involves researching and generating reports on resolved invoices, conducting detailed analyses of patient accounts, payments, and remittance advices from third-party payers. The specialist will also execute complex account adjustments, transfers, and other necessary actions while initiating correspondence with responsible parties or third-party payers as needed. Additionally, this position provides mentorship and guidance to junior Patient Accounts Technicians.

Essential Qualifications:

A high school diploma or GED is required, along with a minimum of 5 years of directly related experience. Candidates with a completed degree from an accredited institution may substitute education for experience on a year-for-year basis. Verification of education and licensure (if applicable) will be required upon selection.

Key Responsibilities:
  1. Analyze and investigate reimbursements from various third-party payers, including Medicare, Medicaid, and other insurers, to verify allowed contracted amounts.
  2. Reconcile and amend patient invoices and accounts to rectify discrepancies; initiate inquiries to third-party payers and/or patients to resolve reimbursement and credit balance concerns.
  3. Respond to inquiries from third-party payers and/or patients regarding reimbursement issues.
  4. Collaborate with internal staff to provide guidance on billing and documentation policies, serving as a liaison with other departments to resolve reimbursement and credit balance matters.
  5. Prepare adjustment and refund request documentation.
  6. Collect, analyze, and summarize data for statistical reporting; maintain data files and logs, and assist in report preparation.
  7. Ensure confidentiality of patient medical and financial records in compliance with federal and state privacy regulations.
  8. Assist in departmental problem-solving, project planning, and the achievement of departmental objectives.
  9. Provide task-specific support and mentorship to other technicians as necessary.
  10. Perform additional job-related duties as assigned.
Why Consider UNM Medical Group, Inc.?

Since our establishment in 2007, we have consistently expanded and built strong partnerships within the UNM Health system. We are committed to embodying values of Service, Positivity, Integrity, and Respect as we strive for Excellence in all our endeavors.

Diversity, Equity, and Inclusion Commitment:

We are dedicated to recognizing, cultivating, and promoting all forms of diversity and fostering health and well-being throughout New Mexico by embracing cultural humility and respect for all individuals.

Benefits:

UNMMG offers a competitive salary and a comprehensive benefits package, including medical, dental, vision, and life insurance, as well as tuition reimbursement, paid leave, and a 403b retirement plan for eligible employees.

Explore the opportunity to join UNM Medical Group, Inc. as a Revenue Cycle Operations Specialist.

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