Department
 

BSD UCP - Revenue Cycle - Revenue Capture

About the Department
 

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 Summary
 

This position is responsible for supporting the Revenue Cycle Team through performance of Provider enrollment activities for the Providers employed by the Advent Medical Group. Network contracts are being updated to include these providers and the Provider Credentialing and Enrollment functions are moving under UChicago. The position is the point person for working with departments, payers other external entities to obtain the necessary information to complete enrollment thereby enabling billing for provider services.

The position also performs billing workflows (e.g. investigate billing or authorization issues related to provider enrollment or resolve Payer system edits related to provider enrollment, etc.) to review/resolve complex provider enrollment issues. Accurately completes data in Provider Enrollment Software to support Roster creation and submission to Payers. This position is able to work remotely.

Responsibilities

Oversees day to day operations for Provider Enrollment functions for assigned providers.

Obtains required information from Providers and their departments in order to complete accurate provider enrollment applications.

Submits applications for designated payers including IL Medicare, IL Public Aid, IN Public Aid, and Railroad Medicare. Tracks status of enrollment applications and performs follow-up activities as indicated to ensure enrollment is completed both accurately and in a timely manner.

Ensures that Provider enrollment data is entered accurately, timely and completely into Provider Enrollment database.

Performs regular Audits to confirm data accuracy and completeness.

Assists with or completes Roster production for payers, as assigned.

Performs re-certification/re-validation of enrollment per schedule mandated by payers.

Troubleshoots and resolves enrollment issues related to claims for provider services.  Contacts payers, Departments or other needed resources to resolve.  Re-submits claims to payers once enrollment issues are resolved, if needed.

Participate in annual and on-going mandatory compliance training and maintain knowledge of regular updates on billing compliance regulations.

Keep informed of changes in policy by reviewing regular Medicare, Medicaid and other payer bulletins and/or other relevant resources. Be knowledgeable of and continually be in compliance with all federal and state health care laws, regulations, and rules, including Medicare and Medicaid billing requirements that are applicable to the employee's job duties.

Review assigned Provider Enrollment processes and current workflows and provides feedback for suggested changes with the intention to improve, implement, communicate and maintain an efficient Revenue Cycle process.

Prioritizes chart documentation and maintaining requirements within the department. Ensures all processes involved in accurately posting professional fees.

Has a moderate/solid understanding of coding procedures, workflow issues, billing infrastructure, and performance of Clinical Revenue staff. Informs department administrators, physicians, and Coder/Abstractors of regulatory changes.

Participates and may lead in training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations in promotion of compliance efforts.

Performs other related work as needed.

Minimum Qualifications
 

Education:

Minimum requirements include a college or university degree in related field.

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Work Experience:

Minimum requirements include knowledge and skills developed through 2-5 years of work experience in a related job discipline.

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Certifications:

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Preferred Qualifications

Experience:

Three years previous experience with physician revenue cycle and payers or provider enrollment.

Previous experience using physician billing/revenue cycle software and electronic medical records systems strongly preferred.

Prior experience with Epic and/or MDStaff software is strongly preferred.

Previous experience and working knowledge regarding third party payer rules, procedures and policies in Provider Enrollment and Billing is strongly preferred.

Licenses and Certifications:

Post high school certification/training related to Revenue Cycle strongly preferred.

Preferred Competencies

Demonstrated ability to interact and communicate with clarity, tact, and courtesy with patrons, patients, Providers, and other persons within the Organization.

Demonstrated ability to participate as a member of the Team in identifying priorities for the work unit and participate as a member of a work group or team.

Demonstrated ability to communicate effectively in English, both orally and in writing.

Demonstrated ability to recognize and resolve or refer problems and conflicts.  Must be able to remain calm and professional when dealing with an upset provider or other customer.

Demonstrated ability to negotiate and manage interpersonal communication effectively.

Confidentiality/discretion must be maintained at all times as will be handling confidential and sensitive information.

Ability to handle multiple concurrent tasks in a competent and professional manner in a fast paced atmosphere.

Ability to work with minimal supervision.

Ability to report to work on time, per schedule and to maintain professional dress/appearance.

Ability to work for long periods of time in a sitting position, or at a keyboard.

Ability to bend/kneel to access files in filing cabinets or storage boxes.

Ability to drive or commute to various sites for occasional meeting.

Ability to work flexible hours on occasion.

Working Conditions

Office environment or Remote Home Office environment.

Pay Range

$65K - $79K

Application Documents

Resume (required)

Cover Letter (preferred)

When applying, the document(s) MUST be uploaded via the My Experience page, in the section titled Application Documents of the application.

Job Family
 

Financial Management

Role Impact
 

Individual Contributor

FLSA Status
 

Exempt

Pay Frequency
 

Monthly

Scheduled Weekly Hours
 

40

Benefits Eligible
 

Yes

Drug Test Required
 

No

Health Screen Required
 

No

Motor Vehicle Record Inquiry Required
 

No

Posting Statement
 

The University of Chicago is an Affirmative Action/Equal Opportunity/Disabled/Veterans and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender, gender identity, national or ethnic origin, age, status as an individual with a disability, military or veteran status, genetic information, or other protected classes under the law. For additional information please see the University's Notice of Nondiscrimination.

 

Staff Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-5800 or submit a request via Applicant Inquiry Form.

 

We seek a diverse pool of applicants who wish to join an academic community that places the highest value on rigorous inquiry and encourages a diversity of perspectives, experiences, groups of individuals, and ideas to inform and stimulate intellectual challenge, engagement, and exchange.

 

All offers of employment are contingent upon a background check that includes a review of conviction history.  A conviction does not automatically preclude University employment.  Rather, the University considers conviction information on a case-by-case basis and assesses the nature of the offense, the circumstances surrounding it, the proximity in time of the conviction, and its relevance to the position.

 

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