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Carle Foundation Hospital Revenue Cycle Accounts Receivable Representative 1 in Urbana, Illinois

Revenue Cycle Accounts Receivable Representative 1

  • Department:

Revenue Cycle

  • Entity:

Carle

  • Job Category:

Financial Services

  • Employment Type:

Full - Time

  • Job ID:

7393

  • Experience Required:

None

  • Education Required:

Not Indicated

  • Shift:

Day

  • Location:

Champaign, IL

  • Usual Schedule:

M-F 8a-5p

  • On Call Requirements:

None

  • Work Location:

Carle at the Fields

  • Secondary Job Category:

Financial Services

  • Weekend Requirements:

None

  • Holiday Requirements:

None

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Position Summary:

The Revenue Cycle Accounts Receivable Representative 1 manages the accounts receivable in accordance with compliance regulatory and billing guidelines and specific payer rules. Responsible for the accurate billing of insurance claims by validating coverage, resolving charge review edits, claim edits and front end clearinghouse and payer rejections. In addition, follows up on outstanding receivables, completes basic appeals, answers, documents and completes inquiries from patients, insurance companies, attorneys, public agencies, internal departments and 3rd party payers.

Qualifications:

EDUCATIONAL REQUIREMENTS Associates degree preferred. CERTIFICATION & LICENSURE REQUIREMENTS None specified EXPERIENCE REQUIREMENTS One year customer service experience in health care preferred. General computer knowledge related to Microsoft Office applications such as Word, Excel and Outlook. Proficient in the use of office based technology i.e. computer, copier, fax, scanner, etc. OTHER REQUIREMENTS Displays a high standard of confidentiality; ability to deal with a large volume of work and the ability to multitask. Maintains a comprehensive working knowledge of assigned payer billing policies and guidelines. Work proficiently within multiple revenue cycle billing systems.

Essential Functions:

  • Identifies and resolves insurance set up errors to facilitate accurate and timely billing.

  • Resolves charge review edits, claim edits and clearinghouse and payer rejections to facilitate accurate billing.

  • Submits claims for assigned payers, including corrected and voided claims.

  • Works patient, account, and follow-up workqueues to perform collection activities on outstanding receivable; contacts patients, payers, attorneys or employers via phone, website/web portal or mail.

  • Reviews and resolves incoming correspondence for outstanding accounts receivable.

  • Resolves underpayments, no payments, overpayments and undistributed payments for proper allocation.

  • Identifies, prepares and requests adjustments.

  • Answers phones to complete inquiries from patients, attorneys, insurance companies, public agencies, internal departments and 3rd party payers.

  • Prepares, completes and follows up on designated payer reports and forms.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

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