Management Tech

Overview

The Cash Management Tech III position will be responsible for analyzing and resolving overpayments in the self-pay and insurance credit portfolios by performing adjustments and/or refunds. This position will be responsible for understanding and applying payer rules for coordination of benefits, contracting agreements, adjustment/refund review, and credit workqueues. The staff will be responsible for answering questions or concerns from patients regarding payments and credits via the billing inquiry process, responsible for answering internal calls from the Cash Management rotation line regarding cash drawers, credit card payments, and various payment issues. This position is required to meet established timelines regarding credit balances.

Qualifications

• Must be able to perform essential job functions of Cash Management Tech 1 and Tech 2.
• Identifies posting errors, insurance coordination of benefits discrepancies, overpayments and adjustments across multiple service areas within Epic or other practice management systems to determine if a refund is due. Knowledge of insurance payers, financial class, remittance advice groups, and ANSI reason codes.
• Identifies overpayments and verify appropriate insurance coverages for coordination of benefits.
• Responsible for understanding and utilizing electronic refund management systems from outside vendors.
• Evaluates and completes various account, credit, charge entry, and adjustment/refund review Epic work queues related to payments and adjustments.
• Raises awareness of the multiple Carle entities, platforms, department locations, bank accounts and reporting of these payments for accounting.
• Accesses multiple third party payers‘ websites to retrieve remittance advice for refund review.
• Maintains an in depth knowledge of ANSI group and reason codes. Interpret overpayments caused by various payment sources including electronic remittance advice; and apply payer, industry, regulatory, and Carle‘s internal payment posting policies and procedures for posting and refunding.
• Performs internal transfers to ensure that patient payments are posted to the correct entity. .
• Responsible for making phone calls to patients and insurance companies to resolve overpayments.
• Responsible for interpreting 835 remittance files and applying this knowledge when reviewing remittance files, credits, vendor periodic payments, and provider level balancing segments. Identifies issues with remittance files for all Carle entities.
• Mentors, trains, and observes staff for quality assurance. Assists with creating training materials and process flows.
• Working knowledge of the OnBase scanning solution and Hyland Virtual Print Drive allowing for documents to be scanned electronically.
• Oversees balancing and trouble shooting of daily patient payment files and working with the vendor (s) to resolve issues.

• Identifies and correct billing errors related to duplicate and incorrect guarantor accounts.
• Collaborates with various departments to ensure appropriate billing and medical record documentation.
• Identifies, reports, and works with the Compliance department regarding inaccurate information resulting in Compliance breeches.
• Responsible for initiating weekly refund reports for balancing weekly refund files and daily intercompany payment transfers. Responsible for working with the IT integrators, system support, and various operational departments to resolve balancing issues related to payment transfers and refunds.
• Assists with locating missing charges for allocation of payments.
• Responsible for working with the Carle accounting group and outside vendors by communicating information regarding stale dated, unclaimed, or returned refund checks.
• Manages void and refund work flow processes for credit card and ACH payment errors from various vendor applications.
• Assists systems staff with interpreting system enhancements, and identifying issues with automation in the workqueues. Assists in analyzing, interpreting, and implementing new EPIC enhancements. Builds, runs, and analyzes management summary reports.
• Handles escalated patient, provider and third party issues in absence of supervisor.
• Evaluate insurance payers for e-commerce opportunities, including working with electronic data interchange departments for appropriate provider enrollment. Evaluate and review payers‘ 835 file structures for compatibility in Epic. Identify and understand new and deleted remittance advice ANSI group and reason codes and coordinate updates with internal departments for billing system actions.
• Trouble shoots issues that departments/floors encounter

Responsibilities

EDUCATIONAL REQUIREMENTS
Associate‘s Degree in Those hired before 6/22/21 are grandfathered for the education requirement

CERTIFICATION & LICENSURE REQUIREMENTS
Valid Driver‘s License Illinois

EXPERIENCE REQUIREMENTS
One (1) year Healthcare. One year experience in health care facility with focus on healthcare finance operations and customer service. Experience in EPIC Practice Management system.

SKILLS AND KNOWLEDGE
Proficient in Microsoft Office applications, Word, Excel, Outlook. Excellent interpersonal, verbal, written and oral communication skills. Detail oriented with ability to handle multiple tasks. Must have the ability to prioritize and complete daily tasks in an environment that has frequent interruptions and competing priorities. Ability to multi-task, prioritize and adhere to work plans to achieve daily standards. Ability to work proficiently within multiple billing systems while identifying multiple Carle entities. Must be self-motivated and dependable to meet department daily goals. Instructional skills for training, mentoring along with quality assurance. Organizational skills. Analytical skills. Mathematical aptitude.

About Us

Find it here.

Discover the job, the career, the purpose you were meant for. The supportive and inclusive team where you can thrive. The place where growth meets balance - and opportunities meet flexibility. Find it all here at Carle Health.

Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,500 team members in its eight hospitals, physician groups and a variety of healthcare businesses and is recognized as a Great Place to Work. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital and Carle Health Pekin Hospital hold Magnet designations, the nation‘s highest honor for nursing care. The system includes Methodist College and Carle Illinois College of Medicine, the world‘s first engineering-based medical school, and Health Alliance. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee‘s Form I-9 to confirm work authorization. | For more information: .

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