Insurance Representative – Patient Financial Services
Day Shift, Full time FTE
Saint Anthony Hospital is a diverse and community-centric organization your career can thrive in, while addressing the health and wellness challenges that families in our neighborhood face. Our employees deliver on our mission and achieve success by working together to provide excellent customer service and patient care.
As part of Saint Anthony Hospital’s commitment to providing the highest quality health care, we will be building a new state-of-the-art hospital to serve as an anchor to the Focal Point Community Campus. Learn more at focalpointchicago.org.
Position Purpose:
- Performs billing, follow-up and collection activities on patient accounts receivable owed to Saint Anthony Hospital/CHP for services rendered while maintaining daily and weekly productivity standards established within the PFS department for this position.
- Responsible for initiating automated claims processing activities using claims editing software for all CHP claims in an efficient, accurate and time conscious manner.
Essential Functions:
- Assists with claims download from host system. Prepares and prints daily and weekly production, management and system reports as required. Ensures that claims are transmitted electronically each day to the appropriate payer. Ensures that clams that cannot be billed electronically are printed and mailed as needed.
- Researches, edits/corrects and transmits any claims rejected by the claims editing software in order to submit them timely to the appropriate intermediary, which may include Medicare, Blue Cross, managed care commercial, and other carriers.
- Collects all outstanding third party balances due to SAH/CHP within the workload assigned while complying with all applicable collection laws and regulations. Contacts third party payers by telephone or electronically to resolve unpaid balances due from the payers.
- Effectively communicates and enforces SAH/CHP payment, charity, bad debt, and other write off policies. Posts write offs and adjustments in the system in accordance with SAH policies and procedures.
- Effectively utilizes collector workstation and other system functionality to prioritize, allocate, and report work. Completes daily and weekly management and productivity reports as required. Documents activities as appropriate in the collection notes and workstation of the system.
- Works denials ($0 payment) from third party payers (via voucher, correspondence, or electronic posting) to correct and re-bill all claims prior to claim filing deadlines. Accounts that cannot be re-billed should be appealed according to the payers guidelines. Reviews and resolves correspondence related to assigned workload to obtain payment. Compiles all credit balance or refund reporting for Medicare and Medicaid.
General Job requirements:
- Knowledge of CMS, Medicaid, Managed Care, and Commercial billing and collection laws, guidelines, and regulations.
- Ability to read and understand provider contracts.
- Knowledge of system support issues that affect billing, collection, and cash application functions.
- 1 to 3 years of billing experience.
- High school diploma: Associates Degree highly preferred.
Saint Anthony Hospital Highlights:
- Saint Anthony Hospital is an independent, nonprofit, faith-based, acute care, community hospital dedicated to improving the health and wellness of the families on the West Side and Southwest Side of Chicago.
- Saint Anthony Hospital has been certified as a Primary Stroke Center by The Joint Commission.
- Saint Anthony Hospital offers competitive wages and a comprehensive benefits program for employees and their families.
- Saint Anthony Hospital employs and teaches some of the city’s brightest, most innovative resident physicians and medical students.
Featured benefits
- Comprehensive Health Insurance Plans/Dental/Vision
- Flexible Spending Account/Health Savings Account
- Employer-matching Retirement Plans
- Paid Time Off & Holidays
- Bereavement Leave/Short Term Disability/Basic & Supplemental Long-Term Disability
- Basic & Supplemental Life Insurance/Accidental Death & Dismemberment Insurance
- Business Traveler’s Accident Insurance
- Critical Illness/Accident Insurance
- Pet Insurance/Legal Insurance
- Tuition reimbursement/Adoption Assistance
- Qualifying Employment for the Public Service Loan Forgiveness Program
Salary Range
$21.22 - $26.24
PI270614028
