IMH PFS Representative, Full Time -Days

UChicago Medicine • Burr Ridge, IL

12h • $23 - $27 • Remote

About The Position

This position is responsible for collections and final resolution of insurance claims, maintains records and reports in accordance with department procedures, meets productivity and quality standards, governing the collection process as defined by the hospital procedures. This position understands and maintains all State and Federal regulation related to billing and collections. All staff in Patient Financial Services are classified under the general title of IMH Patient Financial Services Representative, although position responsibilities and requirements vary based on specific assignment. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area.

Requirements

• High school graduate or equivalent is required
• Ability to interpret contracts, state and federal programs to determine proper reimbursement
• State and Federal regulations regarding HIPPA, billing and collection
• Knowledge of UB04, 837I, 837P, 835, ICD10, and rev codes
• Medicare, Medicaid and Managed Care Billing/Denial Representatives – Requires 1-2 years prior experience working directly with Medicare/Medicaid Claims
• Required: Knowledge of Microsoft Excel, Word and Outlook
• Required: Typing 30 words per minute
• Required: Ten key calculators
• Required: Demonstrates good verbal, written, and comprehension skills
• Required: Ability to follow and complete detailed directions
• Required: Supports an environment of team work
• Required: Ability to work independently as well as part of a team

Nice To Haves

• Two year hospital business office experience preferred
• Preferred: Medical Terminology
• Preferred: Medicare/Medicaid, and Managed Care claims processing in a hospital environment.
• Preferred: Experience with Passport/NEBO/FSS0

Responsibilities

• Processing claims in accordance with state regulatory directives, ensuring government standards are adhered to and possessing continual knowledge regarding new legislation and regulations.
• Working/processing claims and rejections in the billing system on a daily basis to ensure timely filing limits.
• Contacting third parties, insurance companies, attorneys and patients in an effort to collect payments due for services rendered.
• Following up at monthly intervals with a focused effort on large dollars and aging accounts.
• Daily processing of charity, self-pay discounts, refunds, mail, and a variety of other reports related payments and adjustments to maintain our patients billing process to ensure timely statements are received.
• Locating missing or unallocated payments, scanning, bank deposits and researching to resolve posting matters related to PFS.
• Processing short pays, refunds and denials received from payers.
• Verifying the contract and/or working in the denial system to process/refer the denials correctly.
• Processing appeals dependent on the type of the denial.
• Insurance Collections Average 12 accounts per hour and are responsible for non- government payers.
• A/R Cash 120% of prior two months net revenue
• Q/A review will be completed on 5 accounts per month
• Documenting all actions regarding account resolution in a comprehensive and concise manner and in accordance to department requirements
• Seeking assistance for additional options when account resolution has come to a standstill
• Maintaining and complying with regulatory requirements
• Offering ideas in writing to streamline improve procedures
• Offering and developing methods to identify cost savings
• Zero tardiness including forgot to clock in and/or out
• Reviewing all previous account documentation and utilizing information for effective account resolution
• Maintaining Medicare/Medicare (government) knowledge through personal education and development
• Documenting all actions in financial system
• Reporting payment discrepancies
• Performing other duties as assigned
• Balancing accounts
• Working online work list daily

Benefits

• Compensation & Benefits Overview
• UChicago Medicine is committed to transparency in compensation and benefits.
• The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.
• The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis.
• Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity.
• Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.
• Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED