Unified Physician Management

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Claims Coordinator

at Unified Physician Management

Posted: 12/5/2018
Job Status: Full Time
Job Reference #: 672

Job Description

Unified Physician Management (UPM) is the management services organization to Florida’s largest OB/Gyn group practice, Florida Woman Care and to Unified Women’s Healthcare in Texas and Washington. With nearly 1,000 physicians since its inception in 2009, UPM gives physicians the ability to concentrate on their medical practice's growth, the pursuit of quality initiatives, and income growth while improving patient satisfaction. UPM offers comprehensive practice management to its clients, including technology solutions and electronic health records, human resource management, accounting, managed care contracting and management, group purchasing, and data analysis for quality initiatives. 

The Claims Coordinator is an Accounts Receivable Specialist responsible for resolving claims issues arising from denials, underpayments, payments not made according to contractual agreements, and payer processing issues. Duties include but are not limited to:

  • Monitor A/R and Collections of assigned payers
  • Effective communication (written and oral) with internal teams, clients, and payers
  • Follow up on unpaid insurance claims
  • Determine accuracy of Insurance payments and follow up on discrepancies
  • Review and coordinate the appeal of denied claims
  • Identify and resolve Coordination of Benefit issues
  • Run and build reports as required

Skills/ Requirements 

  • Education in lieu of experience considered
  • Minimum of 5 years experience interpreting insurance explanation of benefits, plan benefits, and patient benefits/liability
  • Minimum of 5 years experience working with medical claims (CMS1500, UB04), insurance billing, payment posting, insurance collections, appeals, and medical records requirements/requests
  • Must possess excellent customer service skills communicating logically and clearly (verbally and in writing)
  • Experience and knowledge of insurance payer websites (e-appeals & verification of eligibility)
  • Experience with Microsoft Office
  • Knowledge of Insurance guidelines and contracting information according to industry standards
  • Knowledge of Medical Billing & Coding or Certification is a plus
  • Knowledge of governmental insurance especially Medicare and Medicaid according to industry standards