- Review claims submissions for accuracy by confirming proper payer, authorizations, referrals and all other key billing components.
- Follow clams from submission to payment using EMR analytics, reports, payer portals and other resources as necessary
- Partner with third party billing company personnel to resolve billing issues and support the effort of submitting clean claims with any research in a timely and responsive manner
- Review payer EOBs for a complete understanding of payments and assignment to patient responsibility.
- Use your knowledge of health insurance claim processing, patient policies by payer and payer plan dynamics for commercial, governmental, worker's compensation, labor funds and others to assess accuracy of payments.
- Work diligently to resolve denied/rejected claims by researching and determining the causes of the unpaid claims and making every effort to resolve the denial/rejection in order to promptly resubmit to the payer.
- Respond to patient and/or insurer inquiries in a professional. timely efficient and knowledgeable fashion, ensuring HIPAA and MOC guidelines are followed. and /or refunds as necessary.
- Other job tasks as necessary
- Experience using EMR, EHR and other healthcare/billing related systems to include Allscripts, Mod Med, EPIC, Exscribe, Health Ipass etc., Experience with web portals such as Availity
- Proficiency using Microsoft Excel
- Thorough knowledge of medical insurance terminology and payer explanation of benefits and experience working withmedical benefit plans department of labor for workers comp claims
- Experience with patient assistance and government programs such as Medicare and Medicaid
- Proficient at multitasking and managing competing priorities effectively.
- Effective written and oral communication.
- Minimum HS diploma, college degree desired but not required
- Four years direct experience with core competencies
- Must be able to sit and work at a computer for extended periods of time
- Requires manual finger dexterity and vision corrected to normal range
- Must be able to lift 25 lbs
-
Medical Claims Review Representative
2 weeks ago
Midwest Orthopaedic Consultants Orland Park, United StatesOBJECTIVE: · To ensure that all charges, claims and/or vouchers have been accurately submitted to the appropriate payers in a timely manner and that complete and accurate payment is received from all payers and self-pay patients. · ESSENTIAL DUTIES AND RESPPONSIBILITIES: · Review ...
-
Medical Claims Review Representative
9 hours ago
Midwest Orthopaedic Consultants Orland Park, United StatesOBJECTIVE: · To ensure that all charges, claims and/or vouchers have been accurately submitted to the appropriate payers in a timely manner and that complete and accurate payment is received from all payers and self-pay patients. · ESSENTIAL DUTIES AND RESPPONSIBILITIES: Review ...
-
Midwest Orthopaedic Consultants Orland Park, United StatesJob Description · Job DescriptionObjective: · The Patient Balance Review Representative is responsible for ensuring that outstanding patient balances are reviewed and addressed with the patients to reduce the practice AR. Outstanding balances will require a commitment from the p ...
-
Clinical Research Nurse, Days
2 weeks ago
Northwestern Medicine Orland Park, United States Full timeDescription · The Clinical Research Nurse reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation st ...
-
Customer Service Representative, Overnights
2 weeks ago
Circle K Orland Park, United States Full timeStore : 17940 Wolf Rd, Orland Park, Illinois 60467Availability - Shift/Days · Flexible AvailabilityCustomer Service Representative · We want you to join our team as a Customer Service Representative. If you have the desire to be challenged, work in a fast-paced, fun environment ...
-
Midwest Orthopaedic Consultants Orland Park, United StatesIntake Representative · Our Team · Midwest Orthopaedic Consultants has earned a reputation for supplying timely and high quality medical services. Our patients come first, and our employees play an important role in providing services and maintaining our reputation. We offer 401k ...
-
Financial Services Representative
3 hours ago
Fidelity Investments Orland Park, United StatesJob Description · : Financial Services Representative · Have a passion for helping people? Join our team of Financial Services Representative where you'll have dedicated time to focus on growth and career development, while you support our customers taking inbound calls whil ...
-
Assistant Branch Manager
1 week ago
Tri Counties Bank Orland, United States Full timeCome join Tri Counties Bank...a bank you can be proud to represent and enjoy a comprehensive benefits package that includes an Employee Stock Ownership Plan. This could be the best career move you ever make. · Our Assistant Branch Manager supports the Branch Manager in attaining ...
-
Customer Service Representative
2 weeks ago
Circle K Orland Hills, United States Full timeStore : 9390 W 171st St, Orland Hills, Illinois 60487Availability - Shift/Days · Flexible AvailabilityCustomer Service Representative · We want you to join our team as a Customer Service Representative. If you have the desire to be challenged, work in a fast-paced, fun environme ...
-
Chemotherapy Auth Specialist
2 weeks ago
US Oncology, Inc. Orland Park, United StatesOverview · Join Affiliated Oncologists as a Chemotherapy Auth Specialist · AO specializes in treating a variety of cancers including lymphoma lung, breast, prostate, gynecologic, colorectal and head and neck cancers. Our physicians and staff are multi-disciplinary team of highly ...
-
Patient Service Representative
2 days ago
Orthodontic Experts Ltd Orland Park, United StatesJob Type Full-timeDescriptionAbout us:Orthodontic Experts is dedicated to quality care and orthodontic excellence; we are a community committed to making a difference in our patients' lives. We are looking for the best of the best to join our team as a Patient Service Representat ...
-
Financial Representative
3 weeks ago
Fidelity TalentSource LLC Orland Park, United States· Job Description: · Financial Representative · We believe that as a Financial Representative, you make a key impact on the branch atmosphere, as the official face of Fidelity. Through integrity and honesty, we know you will inspire client dedication and engagement to develop lo ...
-
Patient Service Representative
1 day ago
Orthodontic Experts Ltd Orland Park, United StatesJob Type · Full-time · Description · About us: · Orthodontic Experts is dedicated to quality care and orthodontic excellence; we are a community committed to making a difference in our patients' lives. We are looking for the best of the best to join our team as a Patient Servi ...
-
Clinical Research Nurse, Full-time, Days
2 weeks ago
Northwestern Medicine Orland Park, United States Full timeCompany Description · At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity ...
-
Community Association Manager
2 weeks ago
RowCal Orland Park, United StatesJob Description · Job DescriptionCommunity Association Manager · RowCal is an HOA and Property Management company founded on doing things better. We do it all with a refreshing, can-do attitude and joyful spirit that puts HOA leaders at ease. We'll be a partner that cares, collab ...
-
JobGiraffe Orland Park, United StatesJob Description · Job DescriptionCustomer Service / Administrative / Insurance · Customer Service Representative in Entry-Level Insurance · Will Train to Industry · Up to $37,000 to start plus full benefits · Customer Service Representative you will: · Receive complete training · ...
-
Associate Attorney
2 weeks ago
Proactive Solutions HR Orland Park, United StatesJob Description · Job DescriptionJob Titles: Attorney - Commercial Real Estate or Estate Planning · Location: Orland Park, IL · Job Type: Full-Time onsite · Summary: · Our client is a thriving transactional law firm located in Orland Park, IL, specializing in Commercial Real Esta ...
-
Customer Relations Representative
2 weeks ago
Paul Siano - State Farm Agent Orland Park, United StatesJob Description · Job DescriptionROLE DESCRIPTION: · As a Customer Relations Representative - State Farm Agent Team Member with Paul Siano - State Farm Agent, you will generate the kind of exceptional client experiences that reinforce the growth of a successful insurance agency. ...
-
Account Representative
2 weeks ago
Kira Schnell-Harrison - State Farm Agent Orland Park, United StatesJob Description · Job DescriptionBenefits:401(k) matching · Competitive salary · Flexible schedule · Paid time off · ROLE DESCRIPTION: · As a Account Representative - State Farm Agent Team Member with Kira Schnell-Harrison - State Farm Agent, you will generate the kind of excepti ...
-
Client Relations Sales Specialist
1 week ago
Reidy Law Office LLC Orland Park, United States· Our law office is growing fast, and we're searching for a full-time Client Experience Specialist to help us succeed You'll serve as the compassionate voice of our law firm, fielding inbound calls from prospective clients in their time of need, screening, and surveying for pote ...
Medical Claims Review Representative - Orland Park, United States - Midwest Orthopaedic Consultants
![Default job background](https://contents.bebee.com/public/img/bg-user-ex-1.jpg)
Description
Job Description
Job DescriptionOBJECTIVE:
To ensure that all charges, claims and/or vouchers have been accurately submitted to the appropriate payers in a timely manner and that complete and accurate payment is received from all payers and self-pay patients.
ESSENTIAL DUTIES AND RESPPONSIBILITIES:
COMPETENCIES:
EDUCATION AND EXPERIENCE REQUIRED:
WORKING CONDITIONS/PHYSICAL DEMANDS: