[Hiring] IMH PFS Representative @UChicago Medicine

Role Description

Be a part of a world-class academic healthcare system as a PFS Representative. This is a remote, work from home opportunity and you may be based outside of the greater Chicagoland area.

This position is responsible for collections and final resolution of insurance claims, maintaining records and reports in accordance with department procedures, and meeting productivity and quality standards. Responsibilities include:

• Understanding and maintaining all State and Federal regulations related to billing and collections.
• Processing claims for Medicare, Medicaid, and commercial billing in accordance with state regulatory directives.
• Ensuring compliance with government standards and possessing continual knowledge regarding new legislation and regulations.
• Contacting third parties, insurance companies, attorneys, and patients to collect payments due for services rendered.
• Performing monthly follow-ups with a focus on large dollars and aging accounts.
• Daily processing of charity, self-pay discounts, refunds, mail, and various reports related to payments and adjustments.
• Locating missing or unallocated payments, scanning, bank deposits, and researching posting matters related to PFS.
• Processing short pays, refunds, and denials received from payers.
• Documenting all actions regarding account resolution in a comprehensive and concise manner.
• Maintaining and complying with regulatory requirements.
• Offering ideas to streamline and improve procedures.
• Reviewing all previous account documentation for effective account resolution.
• Maintaining Medicare/Medicaid knowledge through personal education and development.
• Performing other duties as assigned.

Qualifications

• High school graduate or equivalent is required.
• Two years of hospital business office experience preferred.
• Ability to interpret contracts, state and federal programs to determine proper reimbursement.
• Knowledge of state and federal regulations regarding HIPAA, billing, and collection.
• Knowledge of UB04, 837I, 837P, 835, ICD10, and revenue codes.
• 1-2 years prior experience working directly with Medicare/Medicaid Claims for billing/denial representatives.
• Knowledge of Microsoft Excel, Word, and Outlook.
• Typing speed of 30 words per minute.
• Proficiency with ten key calculators.
• Demonstrates good verbal, written, and comprehension skills.
• Ability to follow and complete detailed directions.
• Supports an environment of teamwork.
• Ability to work independently as well as part of a team.

Requirements

• Medical Terminology preferred.
• Experience with Medicare/Medicaid and Managed Care claims processing in a hospital environment preferred.
• Experience with Passport/NEBO/FSS0 preferred.

Benefits

UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position.

• The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis.
• Compensation offered at the time of hire will vary based on candidate qualifications and experience.
• Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union.