Claims Specialist

Responsibilities

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

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.

Performs root cause analysis, identifies edit trends to minimize lag days, mitigates large volume claim submission delays, and maximizes opportunities to improve processes and update the Practice Management System (PMS) logic as needed. Exercises good judgment in escalating identified root causes and edit trends to the Billing Supervisor to ensure timely resolution and communication to stakeholders.

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. Demonstrates the ability to be an effective team player.

The Claims Specialist is a critical role within the physician services unit of IPM, responsible for managing billing claims and ensuring accurate payments.

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.

• 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 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.

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

At UHS and all its subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and its subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.)

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