Claims Specialist

Responsibilities

This role requires a 3-month training period in office and must be within commuting distance to the King of Prussia, PA headquarters.

Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia.

Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve.

To learn more about IPM visit Physician Services - Independence Physician Management - UHS.

The Claims Specialist is responsible for the accurate and timely resolution of professional billing claim and clearinghouse edits as well as payer rejections. This includes registration-based edits, claim requirement data edits (e.g. missing admission date), provider enrollment edits (e.g. missing NPI) and payer-specific edits. Meets or exceeds established performance targets (productivity and quality) established by the Billing Supervisor. Performs root cause analysis and identifies edit trends timely to minimize lag days, mitigate large volume claim submission delays and maximize opportunities to improve process and update the Practice Management System (PMS) logic as needed.

Exercises good judgement in escalating identified root causes and edit trends to the Billing Supervisor, as needed, to ensure timely resolution and communication to stakeholders. Demonstrates the ability to be an effective team player. Upholds “best practices” in day-to-day processes and workflow standardization to drive maximum efficiencies across the team. Communicates effectively with IPM Coders to handle accurate and timely resolution of coding-based claim edits.

High School Graduate/GED required. Technical School/2 Years College/Associates Degree preferred.

• Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment.
• Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, claim submission requirements.
• Understanding of the revenue cycle and how the various components work together preferred.
• Excellent organization skills and attention to detail.
• Service-oriented/customer-centric.
• Strong computer literacy skills including proficiency in Microsoft Office and mainframe billing software (e.g., Cerner, Epic, IDX).
• Ability to handle data entry accurately in a high-paced environment.
• Ability to reconcile data and identify discrepancies.
• Research, and problem-solving ability.
• Results oriented with a proven track record of accomplishing tasks within a high-performing team environment.

• A Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match

and much more!

Independence Shared Services is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee via email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of Independence Shared Services.

No fee will be paid in the event the candidate is hired as a result of the referral or through other means.

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 300 corporation, annual revenues were $15.8 billion in 2024. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune;

and listed in Forbes ranking of America’s Largest…