Reimbursement Specialist/Legal Coordinator

Illinois Bone and Joint Institute LLC • Park Ridge, IL

12d

About The Position

The RCM Legal Coordinator works to ensure that we are optimizing reimbursement for Legal cases such as Workers Compensation Litigation, Auto/Personal Injury Lien, Bankruptcy and Attorney Requests.

Requirements

• Accounts Receivable knowledge: ability to read, analyze and interpret EOB’s, and other AR procedures
• Adheres to organizational policies and procedures, including Corporate Compliance Program, HIPPA regulations.
• Ability to effectively correspond and interact with insurance payers, Attorneys, physi-cians/administrators, co-workers, and management both verbally and in writing.
• Detail Orientated with organizational and problem-solving skills.
• The ability to work in a fast-paced environment
• High School Graduate
• Minimum 2 years’ experience in Healthcare Revenue Cycle
• Strong problem-solving skills and the ability to make timely decisions
• Knowledge of Federal, State and third-party payor reimbursement rules and regulations

Responsibilities

• Communicate directly with the IBJI clinical staff, attorneys, Payers which include adjusters and nurse case managers, Collection agency and patients.
• Utilize online Resources such as the Illinois Workers Comp Commission Website
• Review and analyze claims that are placed on a litigation status or lien status to ensure all claims have been designated appropriately.
• Regular follow up with attorneys on litigated cases to ensure all claims applicable to a case are accounted for and acknowledge by the attorney as active.
• Work with attorneys and Practice administrators as cases are being settled to ensure we obtain the highest level of reimbursement through negotiations.
• Evaluating allowed amounts per the Illinois Workers Comp fee schedule
• Identify errors on patient accounts to ensure all claims are in the appropriate status and to make any corrections needed by working with other RCM departments
• Report monthly on all case statuses
• Ensure Litigation, Settled, Lien, and Bankruptcy worklists are current in our current PM system
• Special projects for Legacy PM systems for IBJI clinics to ensure overlap of systems for a single patient are captured.
• Other duties as assigned

Benefits

• medical, dental, vision, life and AD&D insurance, long and short term disability, 401k program with company match and profit sharing, wellness program, health savings accounts, flexible savings accounts, ID protection plan and accident, critical illness and hospital benefits
• paid holidays and paid time off

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees