Billing Specialist II

4 days ago


IL United States Advocate Health Full time
Job Summary

We are seeking a highly skilled Billing Specialist II to join our team at Advocate Aurora Health. In this role, you will be responsible for daily claims submissions, prebilling and follow-up activity on open insurance claims, and timely and accurate communication with internal teams and external customers.

Key Responsibilities
  • Responsible for daily claims submissions to the appropriate responsible parties, ensuring compliance with regulatory and contractual guidelines.
  • Prebilling and follow-up activity on open insurance claims, exercising revenue cycle knowledge and utilizing multiple systems to resolve outstanding claims.
  • Timely and accurate communication with internal teams and external customers, including third-party payors, auditors, and other entities.
  • Ability to identify and bring patterns and trends to leadership's attention, including coding and compliance, contracting, claim form edits, and credentialing.
  • Accurately enter and/or update patient/insurance information into patient accounting systems, and appeal claims to ensure contracted amounts are received from third-party payors.
  • Comply with and maintain KPIs for assigned payers within standards established by the department and insurance guidelines.
Requirements
  • High School Diploma or General Education Degree (GED)
  • Typically requires 2 years of related experience in a medical/billing reimbursement environment, or equivalent combination of education and experience.
  • Basic keyboarding proficiency and ability to operate computer and software systems in use at Advocate Aurora Health.
  • Ability to read, write, speak, and understand English proficiently, and ability to read and interpret documents such as explanation of benefits (EOB), operating instructions, and procedure manuals.
  • Knowledge of medical terminology, coding, terminology (CPT, ICD-10, HCPCS), and insurance/reimbursement practices.
Preferred Qualifications
  • Ability to problem solve complex billing, coding, and contract issues.
  • Proficient knowledge base and understanding of department-specific policies and procedures.
  • Strong analytic, organization, communication (written and verbal), and interpersonal skills.
What We Offer

Advocate Aurora Health offers a competitive compensation package, comprehensive benefits, and opportunities for professional growth and development.


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