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Reimbursement Specialist

Oak Brook, Illinois
23 Sep 2022

Major Responsibilities:

  • Maintain designated portion of accounts receivable, for both primary and secondary payors.
  • Organization and documentation of bills.
  • Identify, investigate, and verify sources of reimbursement and make decisions based on the information obtained, limited to denied claims, stale claims, payor changes, and additional payor information.
  • Maintain contact with software and hardware vendors for payor/unit-specific applications that are integral to the billing and collection functions (i.e., Florida Shared System, IDPA eligibility software, Private Duty software application).
  • Report on payor changes as appropriate in policy and procedure, including Federal and State regulatory changes, adjustments to reimbursement levels.
  • Responsible for designated weekly, monthly, and quarterly reporting.

Education/Experience Required:

  • High school graduate. 3 years experience in medical billing of medical claims processing.

Knowledge, Skills & Abilities Required:

  • Ability to operate data entry keyboard and 10 key calculator. Working knowledge of PC with experience in other word processing or spreadsheet applications. Orientation to detail and accuracy. Excellent math skills. Excellent knowledge of billing and third party reimbursement. Ability to understand broader scope of operations and adapt to changes accordingly. 1 - 2 years prior successful collection activity and reduction in DSO. Ability to act independently and actively participate in development of action plans. Excellent customer service skills. Good communication skills. Ability to be self-directed and work independently. Ability to identify and set priorities. Ability to interface with a variety of Administrative staff, patients, and family members. Ability to analyze and problem solve. Ability to work in a team environment.
  • N/A

Physicial Requirements and Working Conditions:

  • Travel to other Advocate locations and outside seminars and meetings in all weather conditions on all types of roads.. Ability to work flexible hours with possibility of overtime as appropriate. Ability to work under pressure and meet deadlines.
  • If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06/01/2015. Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case-by-case basis.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

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  • Job Reference: 719479320-2
  • Date Posted: 23 September 2022
  • Recruiter: Advocate Aurora Health
  • Location: Oak Brook, Illinois
  • Salary: On Application