Patient Financial Services Account Representative I

Description

K.S.A.'s : 1. High school graduate required; BS, BA, or CHAA preferred.

2. Minimum 6 months experience in healthcare, hospital, clinics, or physician office environment preferred.

3. Knowledge of ICD-10 coding, medical terminology, third party billing and collections, and managed care requirements.

4. Excellent communication / listening skills.

5. Ability to make quick, accurate decisions on a daily basis.

6. Ability to handle stressful situations.

7. Proficient computer skills and aptitude, Microsoft Office mandatory, Advanced Excel preferred.

8. Substantial interpersonal skills sufficient to work effectively with pediatric patients, families, physicians, nursing, other allied health professionals, insurance professionals and administration.

9. Problem solving ability and able to handle multiple priorities.

10. Thorough knowledge of patient accounting, third party payer procedures, governmental regulations and managed care contracting to be effectively proactive in the billing and collection process, and to respond to inquiries on patient accounts in a customer satisfaction manner.

Job Duties : 1. Create and submit all billing to Government entities, private insurance payers and families; consistent with Federal, State and insurance specific requirements.

2. Resolve all assigned claim edits generated by Epic, the clearinghouse or the payor. Develop strategy to reduce claim edits by collaborating with management and other departments.

3. Identifies Registration, Demographic and Insurance information problems makes all necessary updates. This includes eligibility verification and referral retrieval.

4. Resolve assigned denials and variances, accurately determining the root cause and collaborating to reduce the denial or variance.

5. Ensure that all claims issued timely and are received by the payers.

6. Process assigned inbound correspondence and telephone inquiries from patients and insurance carriers. Promptly responding in writing or verbally.

This includes researching and processing of charge revisions, corrections, adjustments, discounts associated with disputes.

7. Process internal payment transfers between Hospital and Patient Billing, process refund requests for families, governmental and third-party payors.

8. Interacts with Health Information Management, Case Management on claim submission issues which can include obtaining the appropriate Medical Record, or validation of coding.

9. Other job functions as assigned.

Education High School Diploma / GED (Required) Benefit Statement For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes : Medical, dental and vision insuranceEmployer paid group term life and disabilityEmployer contribution toward Health Savings AccountFlexible Spending AccountsPaid Time Off (PTO), Paid Holidays and Paid Parental Leave403(b) with a 5% employer matchVarious voluntary benefits :

Supplemental Life, AD&D and Disability

Critical Illness, Accident and Hospital Indemnity coverage

Tuition assistance

Student loan servicing and support

Adoption benefits

Backup Childcare and Eldercare

Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members

Discount on services at Lurie Children’s facilities

Discount purchasing program

There’s a Place for You with Us At Lurie Children’s we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond.

We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care. Support email :