Denial Coordinator (Hybrid Remote- Days) - The University of Chicago Medicine

Job Description

Be a part of a world-class academic healthcare system at UChicago Medicine as a Denial Coordinator (Collection Coordinator, Medicare) for our Revenue Cycle -PFS Medicare and Commercial division. This is a hybrid remote opportunity where you are expected to come in office as need. Our office location for this role would be at our campus in Burr Ridge, IL.

Job Summary:

This position is responsible to coordinate and manage project and special Medicare Billing and Collection activity according to HCFA guidelines.

Essential Job Functions:

• Assists Manager in Performing Weekly Quality Control on MSP billing situations and MSP form completion by Clinics and Admitting as per Medicare Intermediary and Carrier directions.
• Manages the following high dollar critical billing accounts to assure that all accounts have billed and paid appropriately as per Medicare Intermediary and Carrier direction. Prepare monthly management reports of same activity highlighting potential problem areas and suggest changes to prevent similar problems in the future.          -Kidney Dialysis accounts-Patients dialyzed at two off-site facilities          -Physical Therapy          -Speech Therapy          -Occupational Therapy          -Cardiac Rehab          -Indirect Medical Education – Medicare HMO accounts that qualify for additional funds Additional Documentation Requests-Formal request from Medicare for additional information. Zero billing-Must satisfy HCFA’s requirement to submit MSP claims when no balance is due.
• Acts as an intermediary and with cooperation of Compliance office, interact with Admitting, UCPG, CLINICS, Medical Records, Dialysis Centers and Intermediary/Carrier to reconcile problems associated with any form of billing or collection activity, exercising the strictest limits associated with the confidentiality of patient information.
• Analyzes potential Medicare Bad Debt accounts and recommend bad debt write off as appropriate. Develop and maintain Medicare Bad Debt Logs as per Medicare Intermediary and Carrier directions.
• Oversee special projects such as MSP audits, Compliance office audits and requests, Hospital internal audits, and Senior Management/Attorney requests.
• Identifies Medicare Credit Balances and process appropriate adjustments according to HCFA guidelines and Medicare Intermediary and Carrier directions.
• Assists and advises the Medicare Manager in developing short term and long term goals to reduce backlogs and maintain current billing status.
• Coordinates, develops and documents new procedures to train employees for changes to work flow as required by Medicare Intermediary and Carrier or management.
• Assists and advises Medicare Manager in the development of employee production reports.
• Meets regularly with Compliance office to assure all Medicare regulations are being followed.
• Works with Compliance office to review, interpret and implement new Medicare regulations in Patient Accounting and throughout hospital.
• Attends outside meetings and/or seminars to keep updated on industry changes and developments.
• Stays abreast of Medicare billing and follow up requirements to enable performance as Medicare billing specialist.
• Directs other billing activities in absence of Manager.

Required Qualifications: 

• High school diploma
• A minimum of 3-5 years prior hospital billing and/or collection experience
• Applicant must be able to deal with a high volume of work with stringent production time frames.
• Applicant must be able to identify and solve problems independently but must also be strongly invested in team management and be able to work closely and at times, in an unstructured environment.
• Applicant must have superior writing skills for both external correspondence and internal communication and able to deal effectively with people in a variety of contexts, including staff of a variety of Hospitals departments, patients, physicians, nurses, provider representatives and financial institutions.
• This position requires extensive knowledge of complex policies regarding Medicare billing and collections, state and third party payers’ regulations pertaining to Medicare billing and reimbursement. Must be able to apply this information to effectuate appropriate billing and collection of assigned accounts.
• Applicant must have strong analytic and financial assessment abilities as well as the ability to maintain close attention to a variety of details in order to carry out their responsibilities effectively.
• This position requires a minimum of 1-2 years experience working with a mini or main frame
• collection system environment. Knowledge of personal computers is preferred with a background in developing spreadsheets with computation tables and the ability to produce written reports.

Preferred Qualifications: 

• A Degree in a Business-related field or the equivalent
• 6 months to 1 year of supervisory experience
• Prior Denial experience strongly preferred

Position Details:

• Job Type/FTE: Full Time (1.0 FTE)
• Shift: Days/ 8hr Shifts - Flexible start time between 7am - 8:30am
• Unit/Department: Revenue Cycle - PFS Medicare and Commercial
• Location: Burr Ridge when required to come in office
• CBA Code: Non-Union

Must comply with UCMC’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.

Why Join Us

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, The University of Chicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

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Bring your career to the next level at a hospital that is thriving; from patient satisfaction to employee engagement, we are at the Forefront of Medicine. Take advantage of all we have to offer and #BringYourPassiontotheForefront.

University of Chicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: www.uchospitals.edu/jobs 

The University of Chicago Medical Center is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.