Rev Cycle Regional Rep 2 - Bloomington, United States - Carle Health

Carle Health
Carle Health
Verified Company
Bloomington, United States

2 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

Department:
Revenue Cycle - CFH_10_19


  • Entity: Bloomington-Normal Service Area
  • Job Category: Clerical/Admin


  • Employment Type: Full

  • Time
  • Job ID: 37008
Experience Required: - 3 Years

  • Education Required: HS Diploma/GED
  • Shift: Day
  • Location: Bloomington-Normal, IL
  • Usual Schedule: M-F 84:30
  • On Call Requirements: No
  • Work Location: Carle BroMenn Medical Center
  • Weekend Requirements: No
  • Holiday Requirements: No

Position Summary:
Proficient in Revenue Cycle Regional Representative 1. Responsible for handling escalated account and payer issues. Handles complex edits, appeals and account activities such as advanced level tasks, bankruptcies, Risk Management. Acts as a billing and reimbursement expert for a defined payer product line.


Qualifications:

EDUCATIONAL REQUIREMENTS
Associate's degree preferred.


CERTIFICATION & LICENSURE REQUIREMENTS
None specified


EXPERIENCE REQUIREMENTS

SKILLS AND KNOWLEDGE
Possesses the "other knowledge and skills" of the Revenue Cycle Regional Representative 1. Knowledge of basic medical coding and third-party operating procedures and practices with proficiency in EncoderPro.


Essential Functions:

  • Must be able to perform essential job functions of Revenue Cycle Regional Representative
  • Handles complex edits, correspondence and advanced level workqueues such as but not limited to retro review, EOB balancing, credit adjustment review and processing of Illinois Workers' Compensation Commission (IWCC).
  • Handles escalated account activities such as but not limited to healthcare liens, settlement requests, workers' compensation reimbursement computation forms and attorney requests.
  • Handles escalated appeals.
  • Assists with training and education to staff for accuracy.
  • Identifies payer and system issues to initiate project requests for process improvements.
  • Assists in credit balance review according to organization's credit balance/refund policy.
  • Attends and participates in meetings with payer specific provider representatives to maximize reimbursement and minimize denials through problem solving, collaboration and consensus.
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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