Financial Services Representative 3
The Financial Representative 3 works within the Health Care Finance Department reporting to the Supervisor of Revenue Cycle for Billing and Collections. This individual will work proactively with insurance payers to monitor and resolve payer claim status responses, seek payment, and resolve billing and collection rejection/ denial issues for the assigned patient claims in a timely and compliant manner. He or She will actively support the Supervisor in meeting team monthly /annual targets. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.
Identify, create, and timely resolve special projects to reduce aged accounts receivable and improve collection rates.
Support Supervisor in day-to-day operations and act as leader in the absence of management.
Demonstrate ability to interpret complex contracts and provide pertinent feedback to appropriate parties.
Identify problems impacting daily output and creates solutions within their control.
Demonstrate ability to change group behaviors to support RUSH's goals and financial targets.
Provides insight and knowledge to aid in decision making.
Proactively work with insurance payers to seek payment or resolve claim status and denial issues in a timely and compliant manner with the goal of improving cash collections and reducing aged accounts receivable.
Sound understanding of operational processes as it pertains to Revenue cycle.
Possess a sound understanding of billing and collections processes and eligibility requirements of private and governmental payers.
Perform research on denied claims to resolve all types of denials and reconsiderations including preparing and submitting appeal letters. Monitor and follow up on appeal status.
Identifies, tracks/trends issues and brings possible resolutions to appropriate party.
Autonomous in day-to-day completion of tasks and management of projects.
Escalate accounts to Supervisor when accounts cannot be resolved within 60 days.
Adhere to Rush Mission, Vision and ICARE values.
Attend department & staff meetings and participate in team building meetings and / or events.
Follow and support all of RUSH and Department policies and procedures.
Communicate effectively with peers and internal and external customers.
Exhibit superb written and verbal skills; document clear steps taken and anticipated resolution on accounts.
Develop collaborating relationships with payers and departments throughout the organization.
Proactively challenge processes for improvement opportunities to enhance and streamline operations in daily work and within the department.
Identify and present issues and recommendations to management.
Supports staff training on job related processes.
Monitor the applicable websites (i.e. CMS/NGS/HFS/Payer) for any updates to ensure that our accounts are compliant with Federal, State and Payer requirements.
Complete Rush Corporate Compliance Training (yearly).
Other duties as assigned.
Position Qualifications Include:
Must have a high school diploma or GED equivalent.
Minimum 2 years of previous experience in hospital/professional billing and collections.
Familiarity with medical terminology and coding requirements.
Proficient in MS office products.
Must have superb oral and written communication skills in order to work effectively with a diverse number of internal and external contacts.
Consistently exercises critical thinking skills and uses logic and reasoning to assess and resolve problems.
Participation in training sessions to maintain awareness and knowledge of evolving heath care policy changes.
Rush University is known for its high-quality health care education, supportive learning environment, engagement with the urban community and forward-looking education approach.
Rush University is a health science university that is integral to Rush, an academic health system that includes three hospitals and numerous outpatient care facilities.
Rush University's Doctor of Nursing program is ranked in the top four in the nation by U.S. News & World Report.
Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
Rush University Medical Center