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Illinois Bone & Joint Institute · 1 month ago

Reimbursement Specialist/Legal Coordinator

Park Ridge,IL,US

Full-time

Onsite

Entry, Mid Level

2+ years exp

Illinois Bone & Joint Institute is seeking a Reimbursement Specialist/Legal Coordinator to optimize reimbursement for legal cases including Workers Compensation Litigation and Auto/Personal Injury Lien. The role involves direct communication with clinical staff, attorneys, and payers, as well as reviewing claims and ensuring accurate status designations.

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

Accounts Receivable knowledgeHealthcare Revenue Cycle experienceReimbursement rulesDetail orientedProblem-solving skillsCommunication skillsOrganizational skills

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, physi-cians/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