Careers At UNM Medical Group

Account Operations Tech 3

Department: AR & Denials
Location: Albuquerque, NM

UNM Medical Group, Inc. is hiring for an Account Operations Tech 3 to join our AR & Denials Department.  Remote Position-Selected candidate must have a permanent address and live in New Mexico or be willing to relocate to New Mexico.

Under general supervision, the Account Operations Tech 3 performs a variety of complex functions to resolve involved billing problems and issues. Researches unresolved invoices. Performs complex analyses of patient accounts, patient payments, and remittance advice from third party payers: post complex account adjustments transfers, and other actions. Initiates correspondence to responsible parties or third party payers, as applicable.

Provides day to day guidance and mentor ship to lower level Patient Account Techs as appropriate.

Researches and analyzes claims for various government and commercial third party payers: verifies patient eligibility and adjusts and resubmits claims.

Follows up directly with third party payers either by telephone payer websites or in writing, to resolve outstanding accounts receivable issues.

Following up on denied claims within standard appeal time frame. Submits appeals for payer review paper or electronic.

Identifying and billing secondary or tertiary insurances. Preparing, reviewing, and transmitting insurance claims to clearinghouse or individual insurance companies electronically r via paper CMS-1500 form. Prepares adjustments and refund request forms.

Summary

Under general supervision, performs a variety of complex functions to resolve involved billing problems and issues, and maintains appropriate ledgers. Researches and provides reports on resolved invoices. Performs complex analyses of patient accounts, patient payments, and remittance advices from third party payers; posts complex account adjustment, transfers, and other actions. Initiates correspondence to responsible parties or third party payers, as applicable.

Provides day-to-day guidance and mentorship to lower level Patient Accounts Techs, as appropriate.

Minimum Job Requirements of an Account Operations Tech 3:

High school diploma or GED with at least 5 years of experience that is directly related to the duties and responsibilities specifiedVerification of education and licensure (if applicable) will be required if selected for hire.

Duties and Responsibilities of an Accounts Operations Tech 3:

  1. Analyzes and investigates reimbursements from third party payors, such as Medicare, Champus, Medicaid, Salud, HMO's, and other payors, to determine if contracted amount has been allowed; researches and analyzes third party payor remittance documentation to determine priority of payment and application of adjustments.
  2. Reconciles and applies changes to patient invoices and account to correct account issues; initiates inquiries, either by phone or in writing, to third party payors, and/or patients to resolve reimbursement and credit balance issues.
  3. Responds to requests from third party payors and/or patients regarding reimbursement problems and issues.
  4. Interacts with and advises internal staff regarding billing and documentation policies, procedures, and serves as liaison with other department representatives to resolve reimbursement and/or credit balance issues.
  5. Prepares adjustment and refund request forms.
  6. Collects, analyzes, and summarizes data for preparation of statistical reports; creates and maintains specified data files and logs, maintains computerized systems for collection and tracking of data, and assists in the preparation of reports.
  7. Ensures strict confidentiality of patient medical and financial records, in compliance with federal and state patient privacy legislation.
  8. Assists in departmental problem solving, project planning, and the development and execution of departmental goals and objectives.
  9. May provide task-specific support and guidance to other techs, as appropriate.
  10. 10. Performs miscellaneous job-related duties as assigned.

About UNM Medical Group, Inc.

NM Medical Group, Inc. (UNMMG) is the practice plan organization for physicians and other medical providers associated with the UNM Health Sciences Center. UNMMG is a New Mexico non-profit corporation and is an equal opportunity employer. UNMMG strives to mitigate health disparities brought about by technology; we aim to reach underrepresented populations, making healthcare more equitable and accessible for all of the people in New Mexico; we have a demonstrated commitment to diversity, equity, inclusion, and student success as well as working with broadly diverse communities.

Benefits:

UNMMG offers a competitive salary and an attractive benefit package which includes medical, dental, vision, and life insurance as well as tuition assistance, paid leave and 403b retirement for benefits eligible employees

Notice of Equal Opportunity Employment

We are an equal opportunity employer/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, national origin, sexual orientation, gender identity, marital status, disability, protected veteran status, or any other characteristic protected by law. We are a drug and alcohol free employer.

We are committed to providing reasonable accommodations to individuals with disabilities in the employment application process. If you need an accommodation due to disability to use our online system to apply with the UNM Medical Group, send an email to accommodations@unmmg.org.

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