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Job Description

Business Unit: Rush Medical Center

Hospital: Rush University Medical Center

Department: HB Govt Billing-Collections

**Work Type:** Full Time (Total FTE between 0.9 and 1.0)

**Shift:** Shift 1

**Work Schedule:** 8 Hr (8:00:00 AM - 4:30:00 PM)

Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).

**Pay Range:** $20.19 - $31.80 per hour

Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary:

A Worker’s Compensation Financial Services Representative is responsible for managing the billing and reimbursement process for professional and hospital claims related to workplace injuries, motor vehicle accidents and third-party liabilities. This involves ensuring timely and accurate payment for services rendered to injured employees by healthcare providers, while adhering to Workers' Compensation regulations and guidelines. Exemplify the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Other information:

Required Job Qualifications:

+ HS Diploma/GED

+ 2 years’ experience in a healthcare environment.

+ Strong understanding of Workers’ Compensation regulations and billing procedures.

+ Proficiency in medical coding and billing practices (ICD-10, CPT/HCPCS, etc.).

+ Working knowledge of Epic.

+ Excellent communication, interpersonal, and customer service skills.

+ Strong computer, interpersonal and mathematical skills.

+ Strong organizational and problem-solving skills.

+ Technical aptitude with the ability to quickly gain proficiency with relevant computer applications.

+ Proficiency with Microsoft Office.

+ Ability to perform multiple tasks with strong time management skills.

Responsibilities:

+ Submitting accurate and timely medical bills to worker’s compensation, motor vehicle accidents and third-party liability carriers and attorneys representing the patients.

+ Following up on outstanding claims, including timely appeals for denied or rejected claims.

+ Verifying insurance coverage and patient information.

+ Identifying and resolving billing discrepancies and errors.

+ Writes appeal letters and submit charts when required. Works with all professional and hospital departments as needed to obtain any missing information, identify rationale, and resolve denials.

+ Collaborate with internal teams to address complex billing issues.

+ Manages assigned work queues and documents all activities with narratives of action taken in Epic by using account activities and/or BDC records maintaining detailed records of all collection, denials, or correspondence activities.

+ Identifies trends and assists with developing process improvements for denial avoidance and payment delays.

+ Demonstrates contributions to financial goals reflected by suggested improvements.

+ Communicates with insurance companies, employers, and healthcare providers to resolve billing issues.

+ Analyzing Explanation of Benefits to identify claim denials and develop appeal strategies.

+ Rebilling claims and processing adjustments or refunds as needed.

+ Maintain patient confidentiality by adhering to HIPAA regulations and patient privacy.

+ Willingness to engage in continual education and training in the subject field by participating in educational activities.

+ Assist with training new staff as needed.

+ Other duties as assigned.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

**Position** Financial Services Representative - Collections

**Location** US:IL:Chicago

**Req ID** 21316