Clm Resltion Rep II, Hosp/Prv

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

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With general direction of the Manager/Supervisor/Lead:

• Follows department policies and procedures and maintains and exercises thorough knowledge of insurance company billing requirements and regulations to research and resolve unpaid accounts receivables, making any corrections in the professional billing system necessary to ensure balance resolution for all assigned URMFG physician services.
• Follows up on denied accounts through review of remittances (EOBs), insurance correspondence, rejections received thru daily electronic and claims submission, etc. Researches claims, identifies problems, and takes appropriate action to assure claim resolution. 
• Responds to all billing-related inquiries from colleagues, departments, patients, and payors in a timely and professional manner. Communicates any missing/incomplete information to providers and department administrative support staff to ensure accurate billing. Communicates with insurance representatives through telephone calls, payer website, and written communication to ensure accurate processing of claims.
• Follows established procedure for missing insurance payment information on claims. Keeps management informed of trends. Remains current on changes in billing requirements associated with claim processing and coding.
• Escalate issues that may prevent completion of responsibilities to management. 
• May perform other duties as assigned.

• High School diploma and 2 years of related work experience required
• Associate degree preferred
• Or equivalent combination of education and experience

• Ability to problem solve preferred
• Excellent communication skills preferred
• Ability to put information into a keyboard while typing min of 25 wpm preferred.
• Strong working knowledge of the professional billing software applications preferred
• Excellent customer service skills preferred

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.