Oversees the AR follow-up and denial resolution process with minimal direct oversight while also proactively reviewing current workflows for AR resolution with the intent to improve, implement, communicate and maintain an efficient AR resolution process.
Identifies and resolves the systematic and/or operational root causes of denials and outstanding AR. Oversees and manages the AR follow-up work queues (WQ) and proposes both short and long-term enhancements that support business needs.
Assists manager with maintaining payer scorecards, creating payer meeting agendas, and communicating issues to provider representatives.
Works with the payers on escalated account resolution, identifies and submits high-complexity and other escalated payer projects, proactively reviews payer communication, initiates payer policy and rule change implementation, and proposes changes to front-end or back-end edits.
Creates simple to moderately-complex reports that are necessary for payor projects using a variety of business tools.
Communicates clearly and professionally with the other UCPG units, clinical departments, external vendors, and payers in order to build partnerships that result in denial resolution and prevention.
Provides AR follow-up expertise to other UCPG and UCM business units as needed. Works closely with the Coding Education team to suggest opportunities for coder and provider training.
Assists clinical departments in resolving escalated AR and denial issues. Works with Hospital Billing (HB) team on AR issues that cross between PB, HB, or SBO applications.
Provide AR follow-up training to existing and new AR follow-up staff.
Complete quality audits for denial and AR resolution activities.
Create denial Appeal, Reconsideration, and Medical Necessity letter templates and trains staff in effectively using these templates.
Create workflows and assists manager in developing and documenting policies and procedures.
Competencies:
Ability to learn, apply, and effectively communicate established procedures and processes to support departmental operations.
Strong organizational and time management skills to prioritize tasks and handle multiple responsibilities efficiently.
Analytical thinking and problem-solving skills to review claims, resolve denials, and address operational issues.
Accuracy and attention to detail in data entry, documentation, and record-keeping.
Clear and professional communication skills, both oral and written, with internal teams and external partners.
Ability to work independently with minimal supervision while maintaining accountability.
Teamwork and collaboration to support shared goals and contribute to a positive work environment.
Additional Responsibilities
Education, Experience, or Certifications:
Education:
High School diploma required.
Degree in business, finance, administration, or related field preferred.
Requirements
Background with physician revenue cycle specific AR follow-up and
Benefits
Health insuranceVision insurance
Additional Information
Department
BSD UCP - Revenue Cycle - Revenue Capture
About the Department
The University of Chicago Physician's Group (UCPG) is the central organization that supports the clinical activity of approximately 800 physicians at the University of Chicago. UCPG provides physician revenue cycle management for medical services provided by University physicians and also manages the University of Chicago Health Plan (UCHP). The University of Chicago Practice Plan (UCPP) is the central organization that supports the clinical activity of nearly 750 clinically active faculty practicing at the University of Chicago. These clinically active faculties collectively form the University of Chicago Physicians Group (UCPG) which is located in Burr Ridge, IL. The University of Chicago Physicians' Group (UCPG) is a component of the physician practice plan for the University of Chicago. The UCPG department provides billing services for medical services provided by University physicians and manages the accounts receivable and reporting processes for the Biological Sciences Division (BSD) departments. Each physician is a faculty member and is based in a specified department in the BSD.
Job Information
Job Summary:
Responsible for supporting physician revenue cycle operations by performing routine accounts receivable (AR) follow up and denial resolution activities. Works to ensure timely and accurate claim processing, payment collection, and reduction of outstanding AR.
Communicates with internal departments, patients, and payers to obtain necessary information, resolve claim issues, and support efficient billing operations. Addresses denials and unpaid claims by researching issues, applying established workflows, and escalating complex cases as appropriate.
Maintains assigned work queues, documents actions clearly, and contributes to overall team productivity and quality standards. May assist with basic reporting, participate in training activities, and support process improvements as directed.
Uchicago · Burr Ridge, IL