For over 100 years, West Suburban Medical Center has supported generations of families in the Oak Park and surrounding areas. Our kind, caring hospital staff have a passion to heal and make a difference in our community. We understand that our employees are the heart of our facility. If you are looking for a family atmosphere, a company committed to professional growth and a culture that embraces our five core values of Quality. Innovation. Service. Integrity. Transparency.
JOB SUMMARY
Administers the claims processing for all third party payers and self-pay receivables.
JOB QUALIFICATIONS High School diploma; or two years college course work in finance or equivalent in healthcare setting. Two years billing/collections experience Must have thorough knowledge of third (3rd) party billing and regulations and reimbursement law Proficiency in Lotus, Word Perfect and 10-Key Previous experience with SMS; working knowledge of on-line accounts receivables systems Ability to establish and maintain effective communication with a wide variety of people Ability to define and resolve various issues that impede payment on accounts receivable Ability to read and understand complex financial information and contract terms JOB DUTIES Demonstrates the WMH Customer Service Values, which are key in providing quality service to patients and customers. Schedule patients for various surgeries and procedures Prepare the On - Call schedule and the standard schedule for the OR department Engage with customers and community via phone and in person at the front desk Attend, document, and report updates in the daily huddles Downloads and balances all new claims from the financial system to the respective billing system. Processes claims, either manually or electronically as appropriate for adjudication. Maintains integrity of all data accessed Reviews correspondences received from payers relating to deferred, denied, or incomplete claims and corrects the claims for resubmission to the payer. Monitors and resolves any errors evidenced by system "error" reports and reconciles any billing errors. Monitors trend reports, productivity reports, SMS reports, E-Care reports, Arc Venture reports, and others as required, to identify problems and brings the issues to the attention of the management of PFS. Maintains current knowledge of billing rules and practices through review of literature, networking, formal and informal training. Identifies and relays to management, issues or trends that could affect Hospital cash flow. West Suburban Medical Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
