9 Jobs in kankakee, il
Riverside Healthcare is Hiring a DENIALS ANALYST Near Kankakee, IL
FTE: 1.000000
Shift: Days
Location: HOOVER
SummaryThe Denials Analyst position reports to the Manager of Revenue Integrity. Responsible for immediate review of all denied claims, identification of the basis for filing an appeal, and/or resubmission of an accurate, compliant and timely claim and/or appeal letter resulting in reconsideration by the third party payer or upholding denial resulting in write-offs.
Experience/Education Requirements
- High School graduate or equivalent
- Previous Collections or Insurance experience within last 3 years, preferred
- ICD9/CPT/Medical terminology preferred
- PC and Keyboarding Skills (30 WPM Preferred)
- Ability to work independently
- Two years hospital patient accounting experience, preferred
- Daily review of denials identified by 835 files, manually posted R/As, EOBs, or Payer Correspondence in the Patient Accounting and/or Scanning system.
- Denial prevention - Identify denial trends; provide documentation, data and reporting to Senior Management and offer suggestions for process improvement to areas involved.
- Develop, implement and evaluate existing policies and procedures related to denials management.
- Identify and communicate system issues related to denials stemming from billing, edits, rejections and follow up work queues with the Epic Coordinators and Revenue Cycle Manager.
- Submit help tickets and work with Epic Application Coordinators and/or Analytics to resolve issues, including testing and training as necessary.
- Insure that all Clinical denials are assigned to the appropriate workflow and are written timely by the Utilization Review Staff.
- Maintain attendance at Managed Care In-services, onsite meetings and conference calls with Insurance Provider Representatives.
- Other duties as assigned.
- Provide training to peers assisting with denial management.
- Provides input as well as assisting with quality assurance process initiatives for Riverside Medical Center's Revenue Cycle as related to the improvement of the root cause of the denial.
- Responsible for submitting all Outpatient appeals denied due for Technical reasons.
- Responsible to maintain the Denial Management system and workflow.
- Working with the Application Analyst, the Denials Analyst will thoroughly test and document system upgrades and software modifications related to the Denial Management system.
- Timely follow up on all successfully submitted appeals, by use of work lists and queues, until a determination is made on the appeal.
- HIGH SCHOOL DIPLOMA
Riverside Medical Center proves that truly progressive medicine is being delivered in Chicago's southwest suburbs and East Central Illinois. Join a team that is not only concerned with providing the best care possible but also with offering a work environment of advancement and growth. Riverside is a place that embraces a culture where opinions count and dedications is respected, where superior performance is rewarded with competitive salaries and excellent benefits.
Other InformationExposure/Sensory Requirements
Exposure ToChemicals: Refer to MSDS manual
Video Display Terminals: Average
Blood and Body Fluids: Diagnostic composite of patients, frequent contact with intravenous devices, and high potential for contact with contaminated body fluids (blood, vomitus, stool) and administration of blood does create a high risk. Use of needleless IV system, universal precautions and protective equipment minimize risk..
TB or Airborne Pathogens: Patient diagnostic presentations do pose high risk. Usage of protective wear and universal precautions minimize risk.
Sensory Requirements (speech, Vision, Smell, Hearing, Touch)Speech: Required to communicate with patient/families/staff/doctors, coworkers, ancillary personnel and other department heads. Ability to ask for help.
Vision: Required to perform necessary assessments of patient status, medication administration, CIS usage, and reading active orders and lab reports.
Smell: Helpful to note presence of incontinence, vomitus, blood; electrical/fire safety.
Hearing: Necessary to hear alarms, calls for help and to hear patient verbalizations. Necessary to hear lung, bowel and heart sounds. Needed to hear alarms (i.e., fire, codes via PA system).
Touch: Necessary to perform percussive assessments and to comfort patients. Also needed to manipulate tools and equipment.
Activity/Lifting Requirements
Average Hours per Week: 6-40
Shift: Variable for 24 hour coverage
Percentage of time during the normal workday the employee is required to: Sit: 10%
Twist: 4%
Stand: 40%
Crawl: 0%
Walk: 25%
Kneel: 1%
Lift: 10%
Drive: 0%
Squat: 1%
Climb: 1%
Bend: 30%
Reach above shoulders: 3%
The weight required to be lifted each normal workday according to the continuum described below: Up to 10 lbs: Frequently
Up to 20 lbs: Frequently
Up to 35 lbs: Frequently
Up to 60 lbs: Occasionally
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.): Lifting patients off their beds that are unable to move independently is done with assistive lifting equipment. Horizontal movement of patients to and from carts/beds who are unable to move independently is done with assistive lifting equipment. Lifting equipment - carry 25'-150' waist high (IV bags, patient trays, charts). Filled laundry bags are filled half full so as not to weigh over 35#. Carry fire extinguishers up/down 3-4 flights of stairs and several yards in emergency.
Maximum consecutive time (minutes) during the normal workday for each activity: Sit: 30
Twist: 15
Stand: 60
Crawl: 0
Walk: 10
Kneel: 0
Lift: 5
Drive: 0
Squat: 2
Climb: 1
Bend: 15
Reach above shoulders: 2
Repetitive Use Of Hands (Frequency Indicated)Simple grasp up to 10# Normal weight:
Pushing & pulling - 50-200#: Occasionally
Fine Manipulation: Typing in computer, omnicell, using pens to chart, drawing up meds in syringe and administration, starting IV's.
Leg Strength - up to 50#: Occasionally-(repetitive use of foot or feet in operating machine control: utilized in positioning beds during transport; x-ray, surgery or in an emergency situation from floor to floor, locking beds or cardiac chairs.) Environmental Factors & Special Hazards
Environmental Factors (Time Spent)Inside hours: 12
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere: Odors
Special Hazards: Radiation, Chemical, Explosive - Chemical-drugs; Explosive-oxygen; Radiation-cesium implants and radioactive iodine therapy.
Protective Clothing Required: Gowns, gloves, goggles, masks, HEPA masks for TB.
Job Summary
Full Time
Hospital
$48k-63k (estimate)
06/01/2024
06/16/2024
riversidehealthcare.org
WINSTED, CT
25 - 50
1964
RAJU ABRAHAM
$5M - $10M
Hospital
Related Companies
About Riverside Healthcare
Riverside Healthcare is a fully integrated healthcare system serving the needs of patients throughout the counties of Kankakee, Iroquois, Will, Grundy and beyond. Riverside Healthcare is comprised of five entities: Riverside Medical Center is located in Kankakee, IL and is part of Riverside Healthcare, a fully integrated healthcare system serving the needs of individuals and communities throughout the counties of Kankakee, Iroquois, Will, Grundy and beyond. As part of the system, Riverside Medical Center, a 312-bed hospital, provides a full scope of inpatient and outpatient care and is a natio ...
nally recognized, award-winning Level II Trauma hospital with nationally-leading programs in heart care, cancer care, neurosurgery and orthopedics. Its reputation for nursing excellence has made Riverside the area's only Magnet Recognized hospital. Because Riverside's clinical performance ranks them among the top 5 percent of hospitals nationwide, Healthgrades has named them a Distinguished Hospital for Clinical Excellence Award, and Truven Health Analytics presented them with the 100 Top Hospitals award. Riverside Senior Life Communities address the health care needs of the areas senior population. The four facilities that are a part of Riverside Senior Living Center include: Independent Living, Assisted Living, Riverside Miller Rehabilitation, and Assisted Living & Memory Care at Bourbonnais. Riverside Healthcare Foundation raises funds for the health system for use in facility construction and repair, new equipment acquisition, community health care education initiatives and clinical research. Oakside Corporation operates the Riverside Health Fitness Center and also coordinates community counseling programs, pharmacy, health equipment sales and leasing and home health care. For career opportunities, join our talent network here: http://www.jobs.net/jobs/riverside-medical-center/en-us/all-jobs/
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The job skills required for DENIALS ANALYST include Billing, Accounting, etc. Having related job skills and expertise will give you an advantage when applying to be a DENIALS ANALYST. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by DENIALS ANALYST. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for DENIALS ANALYST positions, which can be used as a reference in future career path planning. As a DENIALS ANALYST, it can be promoted into senior positions as a Patient Accounts Supervisor that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary DENIALS ANALYST. You can explore the career advancement for a DENIALS ANALYST below and select your interested title to get hiring information.
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