Accounts Receivable Tech II

$34,299 - $42,203/Yr

Unm Medical Group - Albuquerque, NM

Full-time - Entry Level

Remote - Albuquerque, NM

Ambulatory Health Care Services

About the position

UNM Medical Group, Inc. is seeking a full-time Accounts Receivable Tech II to join our Revenue Department. This is a remote position, and the selected candidate must have a permanent address in New Mexico or be willing to relocate to New Mexico. The salary for this position ranges from a minimum of $34,299 to a midpoint of $42,203, determined based on years of total relevant experience. The salary is based on a full-time equivalent (FTE) of 1.0 or 40 hours per week, with adjustments made for less than 40 hours per week. The Accounts Receivable Tech II will be responsible for posting receipts into our billing system from Explanation of Payment (EOP) documents from insurance companies and patient payments. This role involves utilizing both electronic postings from 835 files and manual posting. Staff performance is measured by weekly productivity averages and quality checks to ensure compliance with timing requirements and accuracy. As a work-from-home department, initial training will be conducted face-to-face, followed by sessions on Zoom and/or Teams. The work schedule is Monday to Friday, tailored to meet the business needs of the organization while accommodating employee needs. The position requires the employee to start with a limited number of insurance companies to master before gradually being introduced to others, which is expected to take approximately 4 to 7 months. Additionally, the role involves working with credits or overpayments from insurance companies and patients as they post. Quality checks (QCs) are integrated into the billing system to flag any discrepancies, which must be corrected before completing each batch of postings. Under direct supervision, the Accounts Receivable Tech II will perform a variety of routine to complex operations related to posting Electronic Data Interchange (EDI) 835 files, requiring independent research, investigation, and problem resolution. The position demands a high school diploma or GED with at least 2 years of relevant experience, with preference given to candidates knowledgeable in posting payments and resolving denials via 835/EOB/EOP, as well as processing claims, bills, and invoices.

Responsibilities

• Post receipts into the billing system from EOP documents from insurance companies and patient payments.
• Utilize electronic postings from 835 files and manual posting for payment processing.
• Measure staff productivity through weekly averages and quality checks to ensure accuracy and compliance with timing requirements.
• Participate in weekly team meetings and monthly one-on-one meetings for productivity and quality review.
• Start with a limited number of insurance companies for posting and gradually master additional payers over a 4 to 7 month period.
• Work with credits or overpayments from insurance companies and patients during posting.
• Perform daily and monthly reconciliations to the general ledger, including reclassifications and balancing documents of deposits received.
• Research and analyze third-party payer remittance documentation to reconcile payments to remittance advices.
• Follow up with third-party payers and patients to resolve payment posting issues via telephone or in writing.
• Resolve credit balances for patients and between the Hospital and Medical Group and third-party payers.
• Prepare routine patient and third-party payer refund request forms with required documentation.
• Ensure confidentiality of patient medical and financial records in compliance with federal and state legislation.
• Interface with other departmental representatives to resolve identified problems and issues.
• Participate in the development and execution of departmental goals and objectives.

Requirements

• High school diploma or GED with at least 2 years of experience related to the duties specified.
• Completed degree from an accredited institution may substitute for experience on a year-for-year basis.
• Knowledge of posting payments and resolving denials via 835/EOB/EOP is preferred.
• Experience in collecting and/or posting payments and processing claims/bills/invoices is preferred.

Nice-to-haves

• Experience with Electronic Data Interchange (EDI) reimbursements from various payers.
• Familiarity with denial letter reconciliation and general ledger reconciliations.

Benefits

• 403(b) retirement plan
• Dental insurance
• Health insurance
• Life insurance
• Tuition reimbursement
• Vision insurance
• Work from home options