Physician Billing Credit Analyst-1

Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Location

680 Lake Shore Drive

General Summary:

Serves as the primary contact for all insurance companies, third party vendors, and Lurie Children’s departments for cash research and all insurance payor liability balances (PLB) inquiries. Other duties may include, but are not limited to; resolving undistributed payments, processing overpayment requests, posting contractual adjustments, write offs or transfers accordingly to resolve credit balances, resubmitting claims and supporting documentation as needed, and communicating with third party payors in response to overpayment request and/or to obtain insurance hierarchy information.

Essential Job Functions:

• Performs other job-related tasks as assigned.
• Maintains knowledge of all regulations by continually enhancing education specific to federal regulations, payor communications, federal registrars and contractual guidelines to ensure compliance. Is familiar with government and commercial Web Sites and can research and interpret them effectively.
• Performs and resolves complex guarantor account reviews on all financial classes related to credit balances. Performs necessary error corrections and/or initiates a refund request to rectify the account overpayment. Documents all activities/actions taken on an individual patient account within the billing system.
• Ensure PLB transactions are reconciled daily, to ensure accounts are resolved prior to month end close
• Participates actively in department meetings and assumes additional responsibilities and special projects as assigned.
• Works with our internal and external customers to maintain data integrity within patient accounting systems.
• Collaborate with other departments to ensure smooth work processes (Consolidated Services, Accounts Payable, Finance, etc.).
• Participates in scheduled payor meetings by preparing and documenting open issues log (update balances, open negative balances, discussion notes) and dispute spreadsheets
• Actively participates in analysis of work processes; documents and provides feedback to assist in enhancing overall patient satisfaction and work process improvements.
• Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers, and others.
• Work collaboratively with payors to resolve unmatched or unresolved PLB transactions, and internal contacts to identify and rectify billing issues resulting in reimbursement and final disposition of claims. Verifies accuracy of payment for correct reimbursement.
• Act as Epic Super User and Application/Task Tester for Physician Billing projects

Education and Experience:

• Five to seven years of physician or hospital business office experience with significant time spent in communication with patients/families and third-party payers.
• Must be able to track, respond, trend, and multitask within the practice management system.
• Previous Epic experience desired
• Knowledge of windows-based personal computers is required and experience with electronic claims editing software preferred.
• Must be self-directed / self-motivated; must have good communication and interpersonal skills.
• High school graduate required; Associates, BS, BA degree preferred.
• Ability to perform financial analysis and create reports using Microsoft Office products.
• 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.
• Knowledge of ICD-10 coding, medical terminology, and third-party billing and collections processes required.
• Minimum of 4 years of physician revenue cycle billing, follow up, payment posting, and underpayment experience required.
• Excellent communication and listening skills.
• Perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure.
• Strong leadership, planning, and organizational skills with strong analytical ability.
• Strong project management skills with keen attention to details.

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 insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Backup Childcare and Eldercare
• Adoption benefits
• Critical Illness, Accident and Hospital Indemnity coverage
• Discount on services at Lurie Children’s facilities
• Student loan servicing and support
• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members
• Supplemental Life, AD&D and Disability
• Discount purchasing program
• Tuition assistance

Lurie Children’s and its affiliates are equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.

Support email: [email protected]