Advocate Health
Healthcare
AdvancedPaymentSpecialist
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Advanced Payment Specialist at Advocate Health. Skills: Patient billing, Denial analysis, Credit balance reporting. Prepare reports of denials, credit balances, payer opportunities. Analyze rejection reports and errors”
Industry & Context.
Critical thinking; Root cause analysis
Sitting for long periods, Bending, Lift-up to 10 pounds occasionally
What They're Looking For.
Must Have
High school diploma or GED required, Two-years' experience in related financial services or healthcare business office required, Ability to communicate effectively in verbal and written formats
Nice to Have
College (bachelor's or associate) degree preferred, Proficiency in Word, Excel and Outlook preferred, Prior healthcare computer system and specifically Epic billing experience preferred
What You'll Do.
Prepare reports of denials
Analyze rejection reports and errors
Request system changes
Report error rates by teammate
Collaborate with training for improvement
Prepare Medicare/Medicaid quarterly credit balance reports
Assist Supervisor/Manager with quality checks
Perform quality assurance tasks
Validate workflow builds
Validate claim edit actions
Validate automatic actions in Epic
Validate process improvements
Analyze denial reasons provided by payers
Collaborate with management to identify denial root causes
Collaborate with management to trend denial root causes
Collaborate with management to address denial root causes
Research and analyze payer trends
Work on special projects involving aged accounts
Work on special projects involving high dollar accounts
Work on special projects involving complex account issues
How You'll Work.
Team & Collaboration
Collaborate with training; Collaborate with management
Communication Scope
Verbal formats; Written formats
Full Job Description
**Department:** 13452 Enterprise Revenue Cycle - Advanced Payment Team **Status:** Full time **Benefits Eligible:** Yes **Hou****rs Per Week:** 40 **Schedule Details/Additional Information:** Weekdays **Pay Range** $21.85 - $32.80 **Job Summary** Patient Accounts Specialist (PAS) works under the immediate supervision of supervisors/managers in Patient Financial Services (PFS). PAS positions perform complex tasks requiring critical thinking skills and experience-based (specialist) knowledge in PFS. Reviews difficult work queues, large dollar accounts, aged accounts and any special projects assigned by leadership. Creates reports/spreadsheets for identification of problem areas and utilizes critical thinking skills to determine appropriate actions to resolve problem. Must demonstrate thorough knowledge and understanding of patient billing, billing transmission, government regulatory/ compliance requirements, and electronic billing systems. **Essential Functions** * Prepares reports of denials, credit balances, payer opportunities. * Analyzes rejection reports and errors made by system and teammates. Requests system changes, reports error rates by teammate and collaborates with training to ensure improvement is achieved and sustained. * Prepares Medicare/Medicaid quarterly credit balance reports. Approve refunds as defined in departmental threshold guidelines. * Assists Supervisor/ Manager with quality checks for all payers and departments. * Performs quality assurance tasks as needed to validate workflow builds, claim edit actions, automatic actions in Epic, process improvements, etc. * Analyzes denial reasons provided by payers. Collaborates with management to identify, trend and address root causes of denials. * Researches and analyzes payer trends and works on special projects involving aged, high dollar or complex account issues. * Trains new teammates as needed. **Physical Requirements** Requires sitting for long periods of time. Requires bending and may need to
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