Patient Financial Service Account Representative II
Lurie Children's Hospital, Chicago, IL, United States
Patient Financial Service Account Representative II (Follow-Up)
Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report. A Patient Financial Service (PFS) Account Representative II (Follow-Up) works as the last stop on the Revenue Cycle of the hospital. Therefore he/she holds all upstream areas (from our registrars to our clinicians to our coding team) accountable if a breakdown were to occur, or if pertinent information needed for reimbursement is missing. A Follow-Up representative is responsible for resolving unpaid or denied claims, underpayments/overpayments, obtaining claim responses from payers, and working payer correspondence to secure proper reimbursement that is owed. The Follow-Up representative will work within the Epic system to monitor accounts receivable (AR) and take necessary actions to reduce aged AR. This role plays a vital part in the revenue cycle by diagnosing the root cause of the unpaid claim and coordinating with internal departments (as needed) to resolve medical necessity, authorization, coverage and other issues. The Follow-up representative also ensures the hospital is complying with the payer's medical/reimbursement policy and contractual agreements. Ultimately, the Follow-up representative is responsible for the timely and accurate resolution of hospital accounts and the collection of reimbursement to maintain hospital operations. The success of a Follow-Up representative directly impacts and correlates to the hospital's bottom line and allows Lurie Children's to fulfill our mission of serving children in need. Essential Job Functions: Demonstrated mastery of all job functions of Patient Financial Service Account Representative I. Resolve unpaid or denied claims for Government entities, private insurance payers and families; consistent with Federal, State and insurance specific requirements. Diagnose reasons for underpaid/overpaid claims (e.g. contractual agreement discrepancies, incorrect payer plan loaded, incorrect Epic expected reimbursement calculation), and work with appropriate parties to resolve. Contact payers when claim is accepted but no responses/remittances are given timely. Address payer correspondence as needed. Ensure claims comply with payer-specific billing guidelines and regulations. Communicate and collaborate with Revenue Integrity, Case Management, Coding to resolve insurance disputes and denials. Identify recurring issues and works to understand root cause. Escalate trends to management for process improvement and payer escalation. Utilize Epic's real-time eligibility and payer tools to validate insurance data and benefits. Maintain documentation of all actions taken on accounts in accordance with department policies and standards. Meet productivity and quality standards as defined by department leadership. Routinely uses Epic, claims clearinghouse, office software, verbal and written skills to expedite billing of claims and resolution of issues. Other Job Functions as assigned. Knowledge, Skills and Abilities: High school graduate required; BS, BA, or CHAA preferred. Minimum 1 year, 2 years preferred, experience in healthcare, hospital, clinics, or physician office environment preferred. Knowledge of ICD-10 coding, medical terminology, third party billing and collections, and managed care requirements. Excellent communication/listening skills. Ability to make quick, accurate decisions on a daily basis. Ability to handle stressful situations. Proficient computer skills and aptitude, Microsoft Office mandatory, Advanced Excel preferred. Substantial interpersonal skills sufficient to work effectively with pediatric patients, families, physicians, nursing, other allied health professionals, insurance professionals and administration. Problem solving ability and able to handle multiple priorities. Minimum 1 year experience in Patient Financial Services Representative. Education: High School Diploma/GED (Required) Pay Range: $21.00-$32.55 Hourly At Lurie Children's, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children's offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link to learn more about our benefits. Benefit Statement: For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes: Medical, dental and vision insurance Employer paid group term life and disability Employer contribution toward Health Savings Account Flexible Spending Accounts Paid Time Off (PTO), Paid Holidays and Paid Parental Leave 403(b) with a 5% employer match Various voluntary benefits: Supplemental Life, AD&D and Disability Critical Illness, Accident and Hospital Indemnity coverage Tuition assistance Student loan servicing and support Adoption benefits Backup Childcare and Eldercare Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members Discount on services at Lurie Children's facilities Discount purchasing program There's a Place for You with Us: At Lurie Children's, we embrace and celebrate building a team with a variety of backgrounds, skills, and viewpoints
recognizing that different life experiences strengthen our workplace and the care we provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care. Lurie Children's and its affiliates are equal employment opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law. Support email: peoplequestions@luriechildrens.org
Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report. A Patient Financial Service (PFS) Account Representative II (Follow-Up) works as the last stop on the Revenue Cycle of the hospital. Therefore he/she holds all upstream areas (from our registrars to our clinicians to our coding team) accountable if a breakdown were to occur, or if pertinent information needed for reimbursement is missing. A Follow-Up representative is responsible for resolving unpaid or denied claims, underpayments/overpayments, obtaining claim responses from payers, and working payer correspondence to secure proper reimbursement that is owed. The Follow-Up representative will work within the Epic system to monitor accounts receivable (AR) and take necessary actions to reduce aged AR. This role plays a vital part in the revenue cycle by diagnosing the root cause of the unpaid claim and coordinating with internal departments (as needed) to resolve medical necessity, authorization, coverage and other issues. The Follow-up representative also ensures the hospital is complying with the payer's medical/reimbursement policy and contractual agreements. Ultimately, the Follow-up representative is responsible for the timely and accurate resolution of hospital accounts and the collection of reimbursement to maintain hospital operations. The success of a Follow-Up representative directly impacts and correlates to the hospital's bottom line and allows Lurie Children's to fulfill our mission of serving children in need. Essential Job Functions: Demonstrated mastery of all job functions of Patient Financial Service Account Representative I. Resolve unpaid or denied claims for Government entities, private insurance payers and families; consistent with Federal, State and insurance specific requirements. Diagnose reasons for underpaid/overpaid claims (e.g. contractual agreement discrepancies, incorrect payer plan loaded, incorrect Epic expected reimbursement calculation), and work with appropriate parties to resolve. Contact payers when claim is accepted but no responses/remittances are given timely. Address payer correspondence as needed. Ensure claims comply with payer-specific billing guidelines and regulations. Communicate and collaborate with Revenue Integrity, Case Management, Coding to resolve insurance disputes and denials. Identify recurring issues and works to understand root cause. Escalate trends to management for process improvement and payer escalation. Utilize Epic's real-time eligibility and payer tools to validate insurance data and benefits. Maintain documentation of all actions taken on accounts in accordance with department policies and standards. Meet productivity and quality standards as defined by department leadership. Routinely uses Epic, claims clearinghouse, office software, verbal and written skills to expedite billing of claims and resolution of issues. Other Job Functions as assigned. Knowledge, Skills and Abilities: High school graduate required; BS, BA, or CHAA preferred. Minimum 1 year, 2 years preferred, experience in healthcare, hospital, clinics, or physician office environment preferred. Knowledge of ICD-10 coding, medical terminology, third party billing and collections, and managed care requirements. Excellent communication/listening skills. Ability to make quick, accurate decisions on a daily basis. Ability to handle stressful situations. Proficient computer skills and aptitude, Microsoft Office mandatory, Advanced Excel preferred. Substantial interpersonal skills sufficient to work effectively with pediatric patients, families, physicians, nursing, other allied health professionals, insurance professionals and administration. Problem solving ability and able to handle multiple priorities. Minimum 1 year experience in Patient Financial Services Representative. Education: High School Diploma/GED (Required) Pay Range: $21.00-$32.55 Hourly At Lurie Children's, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children's offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link to learn more about our benefits. Benefit Statement: For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes: Medical, dental and vision insurance Employer paid group term life and disability Employer contribution toward Health Savings Account Flexible Spending Accounts Paid Time Off (PTO), Paid Holidays and Paid Parental Leave 403(b) with a 5% employer match Various voluntary benefits: Supplemental Life, AD&D and Disability Critical Illness, Accident and Hospital Indemnity coverage Tuition assistance Student loan servicing and support Adoption benefits Backup Childcare and Eldercare Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members Discount on services at Lurie Children's facilities Discount purchasing program There's a Place for You with Us: At Lurie Children's, we embrace and celebrate building a team with a variety of backgrounds, skills, and viewpoints
recognizing that different life experiences strengthen our workplace and the care we provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care. Lurie Children's and its affiliates are equal employment opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law. Support email: peoplequestions@luriechildrens.org