PFS Rep Home Health, Full time

PFS Rep Home Health, Full time - Days (UChicago Medicine Ingalls Memorial)Join a world‑class academic healthcare system, Ingalls Memorial Hospital, as a Patient Financial Services Representative for our Home Health team in the Medicare and Commercial‑BurrRidge Department. This is a remote, work‑from‑home opportunity and you may be based outside of the greater Chicagoland area.Base Pay Range$26.00/hr – $30.00/hrEssential Job FunctionsFollow best practices in all patient financial services activities.Utilize tools and work queues to identify and prioritize work.Demonstrate teamwork and integrity in all work‑related activities to continually improve services and engage in process improvement activities.Document all patient accounts activities concisely, including future steps needed for resolution.Comply with state and federal regulations, accreditation/compliance requirements, and the Hospital’s policies, including those regarding fraud and abuse, confidentiality, and HIPAA.Perform billing and follow‑up activities for claims.Work daily electronic billing file and submit insurance claims to third‑party payers.Document billing activity on the patient accounts; ensure Hospital compliance with all state and federal billing regulations and report any suspected compliance issues to the appropriate supervisor.Review daily edit reports from the billing system.Prepare and submit manual insurance claims to third‑party payers who do not accept electronic claims or who require special handling.Contact third‑party payers to determine reasons for outstanding claims and communicate with payers to facilitate timely payment of claims.Investigate any overpayments and underpayments and Medicare bad debt reporting policies in compliance with CMS guidelines.Serve as the hospital’s primary contact for all patient billing inquiries. Accept inbound phone calls from patients, physician offices, and insurance carriers.Collect patient payments and follow levels of authority for posting adjustments, refunds, and contractual allowances. Assist patients in understanding billing statements to ensure swift resolution.Review and process financial assistance requests, document approval/denials.Accurately post payments and adjustments, resolve credit balances, and monitor trends and compile reports for leadership.Prepare, post, and process payment batches; post denials, contractual adjustments, and guarantor payments within payment batches; and ensure all payments batches are balanced.Reconcile bank deposit and patient accounts.Investigate the source of unidentified payments to ensure they are applied to appropriate accounts.Analyze EOB information, including co‑pays, deductibles, co‑insurance, contractual adjustments, denials, and more to verify accuracy of patient balances.Reconcile EOBs to make necessary adjustments.Determine reason for credit balances and be responsible for accurate completion and resolution of potential credit balances for health plan payers and patients/guarantors.Identify and examine underpayments/unapplied credits to determine if additional payment can be pursued, or if refund is necessary; follow up with payers and patients as appropriate.Generate refund requests and route the resolution to accounts payable for patients and third‑party payers; refund overpayments and/or transfer payments to the appropriate account/accounts. Responsible for correcting errors in the calculation and posting of insurance contractual adjustments.Required QualificationsHigh school graduate or equivalent.Preferred 3‑5 years of home health and/or hospice insurance billing, insurance follow‑up, insurance denials and/or insurance payment posting experience.Knowledge of the Notification of Admission (NOA) process that has taken the place of the previous Request for Anticipated Payment (RAP) workflows in home health.Understanding of the CMS Outcome and Assessment Information Set (OASIS) process.Excellent critical thinking and analytical skills.Superior communication, organizational, and analytical skills.Strong interpersonal and customer service skills.Ability to multitask and work in a fast‑paced environment.Ability to prioritize tasks, carry out assignments independently and within a team, and to practice good judgment.Preferred QualificationsAssociate degree in business, healthcare, or related field required or a combination of relevant education and experience.Medical Terminology.Proficiency in Microsoft computer programs.Experience with Epic/Sorian.Position DetailsJob Type: Full Time (1.0FTE)Shift: Days – Monday‑Friday (Remote)Department: Finance – Revenue CycleCBA Code: Non‑UnionWhy Join UsFor nearly a century Ingalls Memorial has pioneered sophisticated clinical care and developed the area’s most convenient network of comprehensive outpatient centers, all dedicated to improving the health and wellbeing of the community. Now, partnered with UChicago Medicine, we have expanded our network of expert physicians, convenient facilities and scope of service to speed your healing process and help navigate your path to wellness. A skilled Medical Staff and talented employees dedicated to prevention, diagnosis, treatment and rehabilitation of illness and injury provide a firm foundation for our reputation for quality. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine Ingalls Memorial is for you. Here at Ingalls, we’re doing work that really matters. Join usUChicago Medicine Ingalls Memorial is an equal‑opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.As a condition of employment, all employees are required to complete a pre‑employment physical, background check, drug screening, and comply with the flu vaccination requirements prior to hire. Medical and religious exemptions will be considered for flu vaccination consistent with applicable law.Compensation & Benefits OverviewUChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position. The pay range is based on a full‑time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union. Review the full complement of benefit options for eligible roles at Benefits – UChicago Medicine. #J-18808-Ljbffr