[Hiring] Billing Reviewer I @American Addiction Centers

Role Description

The position is an entry-level performer of charge capture and claim resolution in Epic (electronic health record and patient billing system) for clinical research studies across all regions of the Advocate Enterprise. The position is responsible for performing line-item charge review of research patient encounters in the Advocate Health charge capture system, EPIC.

• Assure the accuracy and completeness of all assigned charges linked to research in EPIC.
• Capture charges for study sponsor or insurance/patient billing of inpatient and outpatient hospital services for research participants.
• Review and allocate research charges in EPIC.

Qualifications

• High School Diploma or GED required; Associates Degree preferred.
• Minimum of 1-year related coding/reimbursement experience preferred.
• Medical terminology knowledge, accounts payable and receivable processes preferred.
• Minimum of 1-year business office experience in a healthcare environment or Research Office experience preferred.
• CPC or RHIT certification preferred.

Requirements

• Perform review of all technical and professional charges generated from EPIC and any ancillary subsystems.
• Perform remediation of charge errors discovered during EPIC review.
• Identify appropriate use of billing modifiers and other CMS requirements for billing research-related charges.
• Verify and resolve discrepancies using available tools and resources.
• Remain knowledgeable about CMS and Fiscal Intermediary medical necessity guidelines.
• Collaborate with clinical research department administrators and study coordinators.
• Supply all missing information and correct inaccurate data as needed.
• Process charge related corrections/additions/removals in EPIC.
• Calculate and facilitate the refunding of inappropriate reimbursement.
• Follow established hospital and physician departmental guidelines and regulations.
• Perform specialized duties involved in the preparation and processing of complex charge issues.
• Audit and review accounts to ensure accuracy; investigate and correct errors.
• Identify insurance issues that need to be forwarded to appropriate teams.
• Prioritize job tasks and assist Manager/Director as needed.
• Demonstrate responsibility for personal development through continuing education.
• Perform other related duties, as assigned.

Benefits

• Base compensation based on qualifications, skills, relevant experience, and/or training.
• Premium pay for shift, on-call, and more based on job role.
• Incentive pay for select positions.
• Opportunity for annual increases based on performance.
• Paid Time Off programs.
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Family benefits such as adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match.
• Educational Assistance Program.