Accounts Receivable Specialist

Independence Physician Management - Wayne, PA

Full-time - Entry Level

Wayne, PA

10,001+ employees

About the position

The Accounts Receivable Specialist at Independence Physician Management (IPM) plays a crucial role in ensuring the accurate and timely follow-up of unpaid and underpaid claims. This position requires a three-month training period in the office, and candidates must be within commuting distance to the King of Prussia, PA headquarters. IPM, a subsidiary of Universal Health Services (UHS), was established in 2012 and focuses on developing and managing multi-specialty physician networks and urgent care clinics that align with UHS acute care facilities. The organization is dedicated to improving health and wellness in the communities it serves, operating in 11 markets across six states and the District of Columbia. As an Accounts Receivable Specialist, you will be responsible for researching claim denials, correcting and reprocessing claims for payment, and meeting or exceeding established performance targets for productivity and quality. You will initiate and follow up on appeals, exercise good judgment in escalating denial trends, and identify uncollectible accounts for timely write-offs. The role demands a strong understanding of payer requirements and the ability to document all actions taken on accounts to ensure clarity in encounter status. You will also participate in team meetings to share denial trends and contribute ideas for workflow improvements. The position requires a high school diploma or GED, with a preference for candidates with technical school or an associate's degree. A minimum of 1-3 years of experience in healthcare revenue cycle management, knowledge of billing processes, and familiarity with CPT/ICD-10 coding is essential. Strong organizational skills, attention to detail, and problem-solving abilities are critical for success in this role. The ideal candidate will be results-oriented and possess excellent computer literacy skills, including proficiency in Microsoft Office.

Responsibilities

• Accurate and timely follow-up on claims that have not received a response, have been denied, or have been under/over paid.
• Work with payers to determine reasons for denials.
• Correct and reprocess claims for payment in a timely manner.
• Proceed with the appeals process as needed.
• Perform eligibility and claim status follow-up inquiries utilizing outbound calls to the payer, web link tools, and payer websites.
• Document all actions taken on accounts worked according to department policy to ensure clear understanding of encounter status.
• Identify root causes and denial trends and make recommendations to department leadership to prevent additional denials.
• Maintain a strong working knowledge of payer requirements and research payer policies to help determine root causes for denial trends.
• Perform accurate write-offs for uncollectible accounts following the identification of such accounts.
• Participate in regularly scheduled team meetings sharing denial trends specific to claim requirements to enhance front end claim edits.
• Contribute ideas for workflows and approaches to A/R follow-up tasks to maximize opportunities for performance, process, and net revenue collections improvement.
• Meet established productivity metrics for the AR Department.
• Meet routinely with Supervisor to review productivity results and understand best practices and opportunities to create efficiencies.
• Meet established quality metrics for the AR Department and collaborate on ways to improve scores.

Requirements

• High School Graduate/GED required; Technical School/2 Years College/Associates Degree preferred.
• 1-3 years minimum experience working in healthcare revenue cycle management.
• Knowledge of healthcare (professional) billing, CPT/ICD-10 coding, government, managed care, and commercial insurances.
• Understanding of claim submission requirements, reimbursement guidelines, and denial reason codes.
• Excellent organizational skills, attention to detail, research, and problem-solving ability.
• Results-oriented with a proven track record of accomplishing tasks within a high-performing team environment.
• Service-oriented/customer-centric attitude.
• Strong computer literacy skills including proficiency in Microsoft Office.

Benefits

• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance