Insurance Representative

Insurance Representative – Pro Fee Billing DepartmentPosition Title: Insurance Representative – Pro Fee Billing Department Full Time Day Shift Compensation: $39K - $58K The estimated range is the budgeted amount for this position. Final offers are based on various factors, including skill set, experience, location, qualifications and comparisons to colleagues in similar roles.Saint Anthony Hospital is a diverse and community-centric organization your career can thrive in, while addressing the health and wellness challenges that families in our neighborhood face. Our employees deliver on our mission and achieve success by working together to provide excellent customer service and patient care.As part of Saint Anthony Hospital's commitment to providing the highest quality health care, we will be building a new state-of-the-art hospital to serve as an anchor to the Focal Point Community Campus. Learn more at focalpointchicago.orgPosition SummaryPerforms billing, follow-up and collection activities on patient accounts receivable owed to Saint Anthony Hospital/CHP for services rendered while maintaining daily and weekly productivity standards established within the PFS department for this position. Responsible for initiating automated claims processing activities using claims editing software for all CHP claims in an efficient, accurate and time-conscious manner situations.Responsibilities1. Assists with claims downloaded from the host system. Prepares and prints daily and weekly production, management and system report as required. Ensures that claims are transmitted electronically each day to the appropriate payer. Ensure that claims that cannot be billed electronically are printed and mailed as needed.2. Research, edits/corrects and transmits any claims rejected by the claims editing software to submit them timely to the appropriate intermediary, which may include Medicare, Blue Cross, managed care commercial, and other carriers.3. Collects all outstanding third-party balances due to SAH/CHP within the workload assigned while complying with all applicable collection laws and regulations. Contact third party payers by telephone or electronically to resolve unpaid balances due from the payers.4. Effectively communicates and enforces SAH/CHP payment, charity, bad debt, and other write-off policies. Posts write offs and adjustments in the system in accordance with SAH policies and procedures.5. Effectively utilizes collector workstation and other system functionality to prioritize, allocate, and report work. Complete daily and weekly management and productivity reports as required. Documents activities as appropriate in the collection notes and workstation of the system.6. Works denials ($0 payment) from third party payers (via voucher, correspondence, or electronic posting) to correct and re-bill all claims prior to claim filing deadlines. Accounts that cannot be re-billed should be appealed according to the payers' guidelines. Reviews and resolves correspondence related to assigned workload to obtain payment. Compiles all credit balance or refund reporting for Medicare and Medicaid. 15%Marginal Functions:Performs both essential and marginal job functions in a safe manner as identified by Saint Anthony Hospital and the respective department while adhering to the Hospital's confidentiality norms and standards. Actively and consistently demonstrates the core values of Saint Anthony Hospital in all interactions with others.Assumes responsibility for knowing and maintaining established hospital and departmental objectives, policies/procedures including general sanitation, safety, environmental and infection control standards.Participates in performance activities including problem identification, data collection, solution selection, implementation and evaluation. Also, assists in the care and maintenance of departmental equipment and supplies as appropriate.Participates in staff meetings and other in-service meetings or committees as required.Work Experience:1 to 3 Years of experience.Position Qualifications:Knowledge of CMS, Medicaid, Managed Care, and Commercial billing and collection laws, guidelines, and regulations.Ability to read and understand provider contracts.Knowledge of system support issues that affect billing, collection, and cash application functions.Previous billing experience preferredBenefits:Comprehensive Health Insurance Plans (Medical, Dental, Vision) **Coverage begins on new hires on the first day**Employer matching retirement plansFree parkingBasic & Supplemental Life Insurance/Accidental Death & Dismemberment InsurancePaid Time Off & HolidaysSaint Anthony Hospital Highlights:Community Hospital with Modern Technology: Work in an environment that blends advanced tools with a mission?driven, community?focused approach.Competitive Salaries: Earn a strong, market?aligned compensation package.Innovative Environment: Be part of a soon?to?come transformation as we transition into a new, next?generation healthcare campus.Collaborative Culture: Join a close?knit team that values communication, teamwork, and mutual support.Professional Growth: Build your skills in an organization that invests in its people and encourages continuous development.Meaningful Work: Serve a diverse patient population and make a real impact on their health journey.Recognition: We are a certified Primary Stroke Center and a respected teaching hospital shaping the next generation of healthcare professionals.EQUAL OPPORTUNITYSaint Anthony Hospital is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment based on age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation, or any other protected status.