Department: 10308 Revenue Cycle - WI HB Non Government Billing Operations Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Full time Monday through Friday 7:00am to 3:30pm. Flexible schedule available. Training is done onsite in Green Bay, WI and then transitions to a full time work REMOTE position. MAJOR RESPONSIBILITIES Independently review accounts and apply billing follow up knowledge required for all insurance payors to insure proper and maximum reimbursement. Uses multiple systems to resolve outstanding claims according to compliance guidelines. Prebilling/billing and follow up activity on open insurance claims exercising revenue cycle knowledge (ie;CPT,ICD-10 and HCPCS, NDC, revenue codes and medical terminology).Will obtain necessary documentation from various resources. Ability to timely and accurately communicate with internal teams and external customers (ie; third party payors, auditors, other entity) and acts as a liaison with external third party representatives to validate and correct information. Comprehends incoming insurance correspondence and responds appropriately. Identifies and brings patterns/trends to leaderships attention re:coding and compliance, contracting, claim form edits/errors and credentialing for any potential in delay/denial of reimbursement. Obtains and keeps abreast with insurance payer updates/changes, single case agreements and assists management with recommendations for implementation of any edits/alerts. Accurately enters and/or updates patient/insurance information into patient accounting system. Appeals claims to assure contracted amount is received from third party payors. Complies and maintains KPI (Key Performance Indicators) for assigned payers within standards established by department and insurance guidelines. Compile information for referral of accounts to internal/external partners as needed. Compile and maintain clear, accurate, on-line documentation of all activity relating to billing and follow up efforts for each account, utilizing established guidelines. Responsible to read and understand all Advocate Aurora Health policies and departmental collections policies and procedures. Demonstrate proficiency in proper use of the software systems employed by AAH. This position refers to the supervisor for approval or final disposition such as: recommendations regarding handling of observed unusual/unreasonable/inaccurate account information. Approval needed to write off balance’s according to corporate policy. Issues outside normal scope of activity and responsibility. MINIMUM EDUCATION AND EXPERIENCE REQUIRED Level of Education: High School Diploma or General Education Degree (GED) Years of Experience: Typically requires 1 year of related experience in medical/billing reimbursement environment, or equivalent combination of education and experience. MINIMUM KNOWLEDGE, SKILLS AND ABILITIES (KSA) Must perform within the scope of departmental guidelines for productivity and quality standards. Works independently with limited supervision. Accountable and evaluated to organization behaviors of excellence Basic keyboarding proficiency. Must be able to operate computer and software systems in use at Advocate Aurora Health. Able to operate a copy machine, facsimile machine, telephone/voicemail. Ability to read, write, speak and understand English proficiently. Ability to read and interpret documents such as explanation of benefits (EOB), operating instructions and procedure manuals. Preferred but not required knowledge of medical terminology, coding, terminology (CPT, ICD-10, HCPC) and insurance/reimbursement practices. Ability to communicate well with people to obtain basic information (via telephone or in person). This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Advocate Aurora Health is one of the 10th largest not-for-profit, integrated health systems in the U.S. with nearly 3 million patients served at more than 500 sites of care in Illinois and Wisconsin, including 28 hospitals. We're redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a variety of specialties. Advocate Aurora Health is one of the 10th largest not-for-profit, integrated health systems in the U.S. with nearly 3 million patients served at more than 500 sites of care in Illinois and Wisconsin, including 28 hospitals. We're redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a variety of specialties. This is Transformation One shared purpose brought us together. Now, as one of the 10 largest not-for-profit, integrated health systems in the United States, our combined strength and stability drives us forward. Starting with You Caring for nearly 3 million people has inspired a transformation. One in which the patient’s experience guides our vision and empowers us to offer new possibilities in our communities. Reshaping Access What is access? It’s offering more sites of care than any other health system in the Midwest. But there’s a new frontier. Access is exploring the latest technologies to deliver care to patients exactly where they are and exactly when they need it Inspiring Professionals With our dynamically inclusive workforce and strong connections to the places where we live and work, we’ll touch more lives and contribute to stronger and more vibrant communities. Transforming Care We’re redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in: Cardiovascular Care Neurosciences Gynecology Oncology Pediatrics Primary Care Neurology Geriatrics Trauma Care