Hospital Reimbursement Specialist
$45,760–$54,080 year
On-siteDes Plaines, Illinois, United States
Job Summary
Contact carriers for follow-up on unpaid facility claims, submit account corrections and adjustments, and manage denials and payment variances. Work with management to identify A/R trends and address root causes while resolving accounts within a timely manner. Verify benefits via online portals or phone and ensure insurance companies have paid correctly per federal and state regulations. Requires familiarity with Commercial, Managed Care, PPO/HMO, and Medicaid/Medicare payors. This role is onsite at Chicago Behavioral Hospital in Des Plaines, Illinois, a 150-bed inpatient mental health facility offering outpatient partial hospitalization programs.
Required Qualifications
- High school graduate or equivalent
- A minimum of one (1) years' experience in a health care collections or related field
- Experience with insurance billing
- Experience with computer and business software programs (Excel)
- Knowledge of Microsoft Office including word, excel, and outlook
- Competence in basic PC skills
- Working knowledge of basic medical terminology
- Understanding of third-party payor rules and regulations
- Ability to read UB04 forms
- Ability to read and understand an EOB
- Ability to identify next steps required when a claim has been denied/rejected
- Strong organizational and communication skills
- Strong ability to prioritize and efficiently manage time
- Proficient computer skills with Microsoft Office
- Familiarity with Commercial insurance
- Familiarity with Managed Care insurance
- Familiarity with PPO/HMO insurance
- Familiarity with Managed Medicare insurance
- Familiarity with Managed Medicaid insurance
- Familiarity with Traditional Medicaid/Medicare insurance
Desired Qualifications
- Education & Licensure: High school graduate or equivalent preferred
- Experience with insurance billing, computer and business software programs (Excel) preferred
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