Carle Health ยท 5 hours ago
Rev Cycle Billing Spec 3- Experience with HomeHealth, Epic, Denials, Follow up and Billing
US-IL-Champaign
Full-time
Hybrid
Mid, Senior LevelCarle Health is a healthcare system with nearly 16,600 team members in its eight hospitals and various healthcare businesses. They are seeking a Rev Cycle Billing Spec 3 who will serve as an expert resource for escalated account activities and assist in optimizing revenue through correct coding and claims appeals.
Hospital & Health Care
Responsibilities
Proficient in Revenue Cycle Account Billing Specialist 2 responsibilities
Additionally, serves as an expert resource for escalated account activities for multiple payer product lines
Responsible for downloading, reviewing, and interpreting payment remittance advice in order to post insurance payments, denials, transfers, and adjustments
Represents Carle in external accounts receivable efforts (examples: court appearances, fair hearings, meetings with employers and insurance companies)
Assists with mentoring, training and observing staff for quality assurance
Assists with creating training materials and process flows
Participates in projects
Involved in system testing and development
Builds and analyzes management summary reports
Serves as a liaison with third party vendors assisting with collection of accounts receivable
Must be able to perform essential job functions of Revenue Cycle Account Billing Specialist 2
Assists with developing policies and procedures, training materials and process flows to ensure best practice
Mentors, trains, observes and educates staff for quality assurance
Facilitates maximization of revenue by ensuring correct coding initiative and payer specific guidelines are applied appropriately and claims are appealed as necessary
Assists with daily department flow, ensures appropriate staffing and optimal productivity levels
Handles escalated patient, provider and third party issues in absence of supervisor
Responsible for downloading, reviewing and interpreting payment remittance advice in order to post insurance payments, denials, transfers, and adjustments
Monitors age trial balance reports for assigned business line to optimize collection of accounts receivable
Participates in system testing and development related to system upgrades and process improvements
Prepares and submits quarterly Medicare credit balance report
Gathers requested documentation for Medicare ADR, CERT and RAC audits
Assists in evaluation of billing opportunities related to new technology and/or services
Builds and analyzes management reports to identify patterns and trends and recommends opportunities for improvement
Participates in projects
Conducts team meetings and provides direction to team members
Represents Carle in external venues such as court appearances, fair hearings, meeting with employers, attorneys, insurance companies, community events etc
Qualification
Required
Proficient in Revenue Cycle Account Billing Specialist 2 responsibilities
Serves as an expert resource for escalated account activities for multiple payer product lines
Responsible for downloading, reviewing, and interpreting payment remittance advice in order to post insurance payments, denials, transfers, and adjustments
Represents Carle in external accounts receivable efforts (examples: court appearances, fair hearings, meetings with employers and insurance companies)
Assists with mentoring, training and observing staff for quality assurance
Assists with creating training materials and process flows
Participates in projects
Involved in system testing and development
Builds and analyzes management summary reports
Serves as a liaison with third party vendors assisting with collection of accounts receivable
Must be able to perform essential job functions of Revenue Cycle Account Billing Specialist 2
Assists with developing policies and procedures, training materials and process flows to ensure best practice
Mentors, trains, observes and educates staff for quality assurance
Facilitates maximization of revenue by ensuring correct coding initiative and payer specific guidelines are applied appropriately and claims are appealed as necessary
Assists with daily department flow, ensures appropriate staffing and optimal productivity levels
Handles escalated patient, provider and third party issues in absence of supervisor
Responsible for downloading, reviewing and interpreting payment remittance advice in order to post insurance payments, denials, transfers, and adjustments
Monitors age trial balance reports for assigned business line to optimize collection of accounts receivable
Participates in system testing and development related to system upgrades and process improvements
Prepares and submits quarterly Medicare credit balance report
Gathers requested documentation for Medicare ADR, CERT and RAC audits
Assists in evaluation of billing opportunities related to new technology and/or services
Builds and analyzes management reports to identify patterns and trends and recommends opportunities for improvement
Participates in projects
Conducts team meetings and provides direction to team members
Represents Carle in external venues such as court appearances, fair hearings, meeting with employers, attorneys, insurance companies, community events etc
Preferred
Associate's Degree
Work Experience: Healthcare business operations
Benefits
Comprehensive benefits package
Company
Carle Health
Carle Health is a vertically integrated system with a bold but simple mission: to be the trusted partner in all healthcare decisions for everyone who depends on it.
Founded in 1946
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Matthew Kolb
Executive Vice President, Chief Operating Officer
Dawn Walden
Senior Vice President, Chief Revenue Cycle Officer
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