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The Carle Foundation

Accounts Receivable Representative - Hospital Billing

The Carle Foundation, Urbana, Illinois, us, 61803


Accounts Receivable Representative - Hospital Billing

JOB SUMMARY:The Accounts Receivable Representative 1 manages the accounts receivable in accordance with compliance, regulatory and billing guidelines and specific payer rules. Responsible for collection of outstanding receivables. 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.EDUCATIONAL REQUIREMENTS:None RequiredCERTIFICATION & LICENSURE REQUIREMENTS:None specifiedEXPERIENCE REQUIREMENTS:One-year 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.SKILLS AND KNOWLEDGE:Strong written and oral communication skills; 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. Works proficiently within multiple revenue cycle billing systems; attention to detail; ability to prioritize and complete tasks under demanding conditions; ability to easily accept and implement change. Must demonstrate tact and diplomacy in all interpersonal interactions.ESSENTIAL FUNCTIONS:Prior Hospital BillingIdentifies and resolves billing and 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 work queues to perform collection activities on outstanding receivables; contacts patients, payers, attorneys or employers via phone, website/web portal or mail.Reviews and resolves incoming correspondence.Resolves underpayments, no payments, overpayments and undistributed payments for proper allocation.Identifies, prepares and requests adjustments.Responds to inquiries from patients, insurance companies, public agencies, internal departments and 3rd party payers.Prepares, completes and follows up on designated payer reports and forms.Performs other duties as assigned.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. We are committed to creating a diverse and welcoming workplace that includes partners with diverse backgrounds and experiences. We believe that enables us to better meet our mission and values while serving customers throughout our communities. People of color, women, LGBTQIA+, veterans and persons with disabilities are encouraged to apply. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal state and local ordinances. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization.Effective September 20, 2021, the COVID 19 vaccine is required for all new Carle Health team members. Requests for Medical or Religious exemption will be permitted.

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