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Health Care - Financial Representative - Credit Balance Analyst*

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POST DATE 9/17/2016
END DATE 10/29/2016

Rush University Medical Center Chicago, IL

Company
Rush University Medical Center
Job Classification
Full Time
Company Ref #
2016-1975
AJE Ref #
576206778
Location
Chicago, IL
Experience
Mid-Career (2 - 15 years)
Job Type
Regular
Education
High School Diploma or GED

JOB DESCRIPTION

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JOB DESCRIPTION:



POSITION HIGHLIGHTS:

THE FINANCIAL REPRESENTATIVE - CREDIT BALANCE ANALYST IS RESPONSIBLE FOR RESOLVING CREDIT BALANCE ACCOUNTS EITHER THROUGH CONTRACTUAL ALLOWANCES OR THE REFUNDING OF CHECKS. MAIN OBJECTIVE IS TO ESTABLISH STANDARDS FOR THE PROMPT IDENTIFICATION AND RESOLUTION OF CREDIT BALANCES AND REFUND OF MONIES AS APPROPRIATE.



THE INDIVIDUAL WHO HOLDS THIS POSITION ADHERES TO THE POLICIES AND PROCEDURES MANDATED BY THE APPROPRIATE INSTITUTIONAL AGENCIES, EXEMPLIFIES THE RUSH MEDICAL CENTER MISSION, VISION AND VALUES, AND ACTS IN ACCORDANCE WITH RUSH POLICIES AND PROCEDURES.



RANKED AMONG THE TOP ACADEMIC MEDICAL CENTERS IN THE COUNTRY, RUMC IS AN OUTSTANDING PLACE TO ENHANCE YOUR CAREER AND CONTRIBUTE TO OUR ULTIMATE MISSION OF IMPROVING PATIENT CARE

POSITION RESPONSIBILITIES:



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Review daily credit balance work list to initiate research of credit balance accounts.
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Review potential patient liabilities on credit balance accounts prior to recommending patient refunds and perform balance transfers as appropriate per department policies.
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Maintain knowledge base and update all new, current and terminated insurance contracts with the Medical Center..
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Participates in the quality and process improvements as identified and needed by the department.
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Obtain all pertinent back-up data as follows: EOBs, insurance company correspondence, calculation sheets, refund letters of explanation and explanation of reimbursement from EPIC/PMMC.
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Exceeds daily and weekly volume/productivity management reporting while maintaining a high quality review score
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Determines proper COB (Coordination of Benefit) when more than one insurance company is involved and COB reimbursement clause per contract to calculate the proper expected reimbursement
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Identify misapplied cash or an incorrect adjustment and makes the necessary changes in patient accounting system
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Complete formal refund requests and attach all supporting documentation within EPIC or Availity systems.
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Responsible for the tracking of RCR s in the eRM application for BCBS refunds and adhering to the timeframe guidelines per policy.
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Reconcile eRM weekly to ensure the proper retractions are submitted from future remits.
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Prepare spreadsheets for payors in regards to special projects involving erroneous refunds and payer retractions.
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Attend monthly payor meetings and keep payors informed of trends regarding refunds and/or retractions and obtain policy changes and notifications.
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Identify discrepancies with Managed Care Contracts and report those discrepancies to the Rush Health/Contracting.
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Act as a liaison between Rush Health and Finance regarding payer related trends and issues regarding refund requests.



POSITION QUALIFICATIONS INCLUDE:



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Must have a high school diploma, GED equivalent, or higher level degree.
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Minimum 5 years prior experience in hospital revenue cycle with responsibilities for billing an collections.
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Minimum 2 years experience working directly with managed care payor reimbursements.
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Demonstrated experience with managed care contractual interpretation.
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Prior experience with Epic Hospital Billing strongly preferred.
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Experience with various health care revenue cycle applications.
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Intermediate proficiency in Word and Excel.



COMPANY HIGHLIGHTS:

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Rush is a not-for-profit health care, education and research enterprise comprising Rush University Medical Center, Rush University, Rush Oak Park Hospital and Rush Health.
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Leading academic medical center, acute care hospital w/ 676 licensed beds and a four time Nursing Magnet Hospital.
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RUMC offers a competitive salary, outstanding benefits & the professional advantages of an environment that supports your development & recognizes your achievements.



RUSH UNIVERSITY MEDICAL CENTER IS AN EQUAL OPPORTUNITY EMPLOYER THAT WELCOMES AND ENCOURAGES ALL APPLICANTS TO APPLY REGARDLESS OF AGE, RACE, SEX, RELIGION, COLOR, NATIONAL ORIGIN, DISABILITY, VETERAN STATUS, SEXUAL ORIENTATION, GENDER IDENTITY AND/OR EXPRESSION, MARITAL OR PARENTAL STATUS, ANCESTRY, CITIZENSHIP STATUS, PREGNANCY OR OTHER REASON PROHIBITED BY LAW.