Lake County IL-posted 2 months ago
Waukegan, IL
1,001-5,000 employees
Administration of Human Resource Programs

Under general supervision performs work assisting with the administration of the Health Department's central billing office management program. The position has the responsibility for reviewing, researching, analyzing and acting upon all claim rejections received from Medicaid, Medicare, private insurance and all other revenue sources. Services include medical, mental health, substance abuse and dental. Ensures accurate records are kept for all billing activity to ensure the agency complies with all appropriate regulations as required. Provides various patient management reports as needed. Assists with other billing projects as needed.

  • Processes and analyze claim rejection reports from the NextGen, Waystar systems and act upon the findings in a timely manner.
  • Analyze the explanation of benefit advises from the various payers to ensure the accuracy of the data entered into NextGen for Medicaid, Medicare, private insurance and other third party payers.
  • Re-bill and adjust patient accounts as necessary using the NextGen system.
  • Create patient management reports using the NextGen system.
  • Analyze and resolve accounts receivable aging issues.
  • Use Microsoft Excel to create spreadsheets to assist in the analysis of patient data.
  • Analyze pending insurance account payer accounts in the NextGen system in order to have accurate processing of claims.
  • Analyze and correct patient sliding fee adjustments in NextGen as needed.
  • Trace the transactions through NextGen from charge entry through claim creation as part of problem resolution.
  • Differentiate between clearing house rejections and payer rejections by frequently working within the Viatrack clearing house environment.
  • Resolve all billing inquiries from internal and external customers.
  • Gives appropriate information referrals and documents as necessary.
  • Keeps thorough records of all activity including reporting and tracking of billing adjustments or corrections.
  • Participates in staff meetings, in service trainings, and seminars to facilitate professional growth and maintain licensure if required.
  • Involvement in quality improvement activities on an ongoing basis.
  • Assists with other projects and duties as assigned.
  • Completion of a high school diploma or G.E.D. certificate.
  • Demonstrated relevant experience in a medical billing or accounting office setting is required.
  • Bilingual is preferred.
  • Associate's Degree or certification in medical technology or accounting is preferred.
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