Illinois Bone & Joint Institute · 1 month ago
Reimbursement Specialist/Legal Coordinator
Illinois Bone & Joint Institute is focused on optimizing reimbursement for legal cases. The RCM Legal Coordinator will communicate with various stakeholders, analyze claims, and ensure proper reimbursement through negotiations and follow-ups.
Health CareMedicalTherapeutics
Responsibilities
Communicate directly with the IBJI clinical staff, attorneys, Payers which include adjusters and nurse case managers, Collection agency and patients
Utilize online Resources such as the Illinois Workers Comp Commission Website
Review and analyze claims that are placed on a litigation status or lien status to ensure all claims have been designated appropriately
Regular follow up with attorneys on litigated cases to ensure all claims applicable to a case are accounted for and acknowledge by the attorney as active
Work with attorneys and Practice administrators as cases are being settled to ensure we obtain the highest level of reimbursement through negotiations
Evaluating allowed amounts per the Illinois Workers Comp fee schedule
Identify errors on patient accounts to ensure all claims are in the appropriate status and to make any corrections needed by working with other RCM departments
Report monthly on all case statuses
Ensure Litigation, Settled, Lien, and Bankruptcy worklists are current in our current PM system
Special projects for Legacy PM systems for IBJI clinics to ensure overlap of systems for a single patient are captured
Other duties as assigned
Qualification
Required
Accounts Receivable knowledge: ability to read, analyze and interpret EOB's, and other AR procedures
Adheres to organizational policies and procedures, including Corporate Compliance Program, HIPPA regulations
Ability to effectively correspond and interact with insurance payers, Attorneys, physicians/administrators, co-workers, and management both verbally and in writing
Detail Orientated with organizational and problem-solving skills
The ability to work in a fast-paced environment
High School Graduate
Minimum 2 years' experience in Healthcare Revenue Cycle
Strong problem-solving skills and the ability to make timely decisions
Knowledge of Federal, State and third-party payor reimbursement rules and regulations
Benefits
Medical
Dental
Vision
Life and AD&D insurance
Long and short term disability
401k program with company match and profit sharing
Wellness program
Health savings accounts
Flexible savings accounts
ID protection plan
Accident
Critical illness and hospital benefits
Paid holidays
Paid time off
Company
Illinois Bone & Joint Institute
Illinois Bone & Joint Institute is a health unit center that provides orthopedic solutions related to joints and chronic diseases.
Funding
Current Stage
Late StageRecent News
2024-10-25
Company data provided by crunchbase