Join a world-class academic healthcare system, Ingalls Memorial Hospital, as a Patient Financial Services - Refund Specialist in the Patient Accounts department.
In this role as a Refund Specialist, you will will be responsible for the account receivables management. This position requires detailed analysis and critical thinking. Ingalls Memorial Hospital serves Chicago's south suburbs. We strive to be the best health care provider supply chain. Our goal is to be one of the best in any industry by ensuring the right products, services and equipment are always delivered to the right place at the right time. We are also committed to delivering the best quality with the lowest total cost.
This position promotes revenue integrity and accurate reimbursement for the organization by enduring timely and accurate billing and collection of accounts.This individual must follow departmental productivity and quality control measures that support the organization's operational goals.This position is responsible for collections and final resolution of insurance claims, maintains records and reports in accordance with department procedures, meets productivity and quality standards, governing the collection process as defined by the hospital procedures. This position understands and maintains all State and Federal regulation related to billing and collections.
Essential Job Functions
- Participates in process improvement and cross-training activities on an ongoing basis
- Keeps management abreast of any outstanding problems, and updated on the timeliness of posting.
- Documents all actions regarding account resolution in a comprehensive and concise manner and in accordance to department requirements
- Seeks assistance for additional options when account resolution has come to a standstill
- Maintains and complies with regulatory requirements
- Offers ideas in writing to streamline improve procedures
- Maintains and monitors integrity of the claim development and submission process.
- Acts as a liaison between patients, providers, and payers for all post-care matters related to account resolution.
- Must be able to solve problems within the guidelines of established policies and procedures
- Maintains thirdparty payer relationships, including responding to inquiries, complaints, and other correspondence.
PFS Representatives will be assigned to and support one or more of the following departments:
- Billing & Follow Up - Denials
- Accounts Receivable Specialist
- Medicaid/Medicare and Managed Care Billing
- High school graduate or equivalent is required
- Ability to interpret contracts, state and federal programs to determine proper reimbursement
- State and Federal regulations regarding HIPPA, billing and collection
- Knowledge of UB04, 837I, 837P, 835, ICD10, and rev codes
- Knowledge of Microsoft Excel, Word and Outlook
- Typing 30 words per minute
- Ten key calculators
- Demonstrates good verbal, written, and comprehension skills
- Ability to follow and complete detailed directions
- Supports an environment of team work
- Ability to work independently as well as part of a team
- Associate's degree in business, healthcare, or related field required or a combination of relevant education and experience
- Two year hospital business office experience preferred
- Medical Terminology
- Medicare/Medicaid, and Managed Care claims processing in a hospital environment.
- Experience with Passport/NEBO/FSS0
- Job Type: Full Time
- Shift: Days Shift 7am-3:30pm Monday-Friday
- Office Location: Burr Ridge - Remote opportunity with occasional requirements to come in office as needed
- Department: Finance - Revenue Cycle
- CBA Code: Non-Union
Must comply with Ingalls Memorial Hospital's COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.
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