Job Information
Rush University Medical Center Financial Services Representative 2 - Hospital and Physician Billing in Chicago, Illinois
Job Description
Location: Chicago, IL
Hospital: RUSH University Medical Center
Department: Otolaryngology PBC
Work Type: Full Time (Total FTE between 0.9 and 1.0)
Shift: Shift 1
Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM)
Summary:
General purpose of the position is to manage the open receivable including, securing reimbursement, guarding the Medical Centers assets, minimizing financial risk, working on behalf of our patient's financial liability. The Financial Services Representative 2 is also responsible for responding to internal audits. The ultimate goal of this position is to decrease receivables and increase quality and productivity. This role includes performing re-bills, Debit & Credits, adjustments, refunds, and claim corrections resulting from the multitude of claims and payer edits as well as notifying denial management of audits. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.
Coordinates specified Accounts Receivable activities to ensure that accounts are consistently followed up in a timely manner and that stated goals are met. Serves as "trouble shooter" with problem accounts to maximize reimbursement. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.
Responsibilities:
Actively manage account balances to ensure that we are compliant with Federal and State regulatory requirements and evaluate each account to ensure that each account balance is collected in accordance to contract allowable payment schedule.
Follow up on claims with the appropriate payer for reimbursement.
Work directly with various departments to insure the charges are properly credited and / or debited.
Develop, manage, and maintain various electronic documents used to manage these projects.
Develop and report status of the trend issues weekly.
Eagerly accept challenging assignments. Collaborate with other departments, physician offices, and other clinical areas to ensure charges and diagnosis are consistent and that the financial information being used is correct during the billing process.
Communicate constructively with patients and other Rush departments to achieve mutually positive business and service outcomes.
Monitor Illinois Healthcare and Family Services (HFS), website for any updates to ensure that our accounts are compliant with Federal and State requirements.
Work within your team to insure the team has all related job work flows and processes.
Monitor system enhancements - Develop and communicate constructive feedback/issue solutions for problems as discovered.
Collaborate with other departments, physician offices, and other clinical areas to ensure charges and diagnosis are consistent and that the financial information being used is correct during the billing process.
Develop, implement, & monitor system enhancements.
Develop and communicate constructive feedback/issue solutions for problems as discovered.
1.Has primary responsibility for following up on the AR to maximize reimbursement.
2.Works individual accounts from a prioritized work list. Contacts payor or patient/guarantor as needed. Confirms current outstanding account balances and performs appropriate account follow-up activity.
3.Requests additional documentation from Medical Records or other departments as necessary to adjudicate the account balance.
4.Reviews accounts for appropriate referral to pre-collection agencies.
5.Monitors contractually agreed upon payment timeframe for all payors.
6.Analyzes and responds to claim denials and other written correspondence from third-party payors.
7.Receives and resolves zero payment denials, when appropriate; also receives, accesses and resolves denied payment vouchers from state or federal government payors, when appropriate.
8.Follows through to completion on special projects assigned by supervisor. Researches all elements thoroughly, utilizing own knowledge and appropriate outside sources to resolve all matters relating to such projects.
9.Takes responsibility for analyzing posted payments versus expected payments as needed. If there are any accounts that are in question, thoroughly researches before an adjustment is made.
10.Completes daily and weekly volume/productivity/management reports as specified by management.
11.Participates in quality management processes.
12.Attends training sessions as specified by Supervisor.
Other information:
Required Job Qualifications:
• High School Diploma or GED.
• Two years of experience in health care or hospital billing with an understanding of coverage eligibility requirements for governmental payers.
• Previous experience in a hospital setting, familiarity with medical terminology and patient fiscal matters.
• Familiar with Nebo's eCare billing editors such as Classic and CMS. Strong familiarity with medical terminology and patient financial matters.
• Specific knowledge of Microsoft Office in order to design, implements, tracks, and maintain moderately complex statistical information.
• Strong analytical skills including statistical, mathematical, and organization abilities necessary for accurate reporting to payers and management.
• Strong interpersonal skills for communication of finance-related issues to management and ancillary departments.
• Sound understanding of billing and collection processes and eligibility requirements of private and governmental payers.
• Able to work independently.
• Good time management skills and possess the ability to multi-task.
• Good oral and written communication skills in order to work effectively with a diverse number of internal and external contacts.
Preferred Job Qualifications:
• Prior experience using Epic for hospital billing.
Required Job Qualifications:
·High School Diploma or GED.
·Experience with accounts receivable process and basic accounting principles, computer accounting programs, spreadsheets and applications, medical terminology, coding and office procedures, and medical billing system.
·Skill in establishing and maintaining effective working relationships with other employees, patients, organizations and external customers; develops, implements and produces complex reports.
·Ability to process patient and external customer inquiries and respond with poise and efficiency.
·Recognizes, evaluates, solves problems and corrects errors.
·Maintains confidentiality of sensitive information.
Preferred Job Qualifications:
·Five years of medical business office experience.
Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
Position Financial Services Representative 2 - Hospital and Physician Billing
Location US:IL:Chicago
Req ID 6282