Skokie, IL

Position Highlights:

• Position: Payment Variance Representative
• Location: Skokie, IL
• Full Time/Part Time: Full Time
• Hours: Monday-Friday, 8 AM to 4:30 PM

What you will need:

• Education: High school diploma is required. 2 years post-high school education or degree is preferred.
• Experience: One year of work experience required. Previous experience as a biller or follow-up representative in healthcare accounts receivable environment is preferred.
• Skills
  • Knowledge of basic accounting principles and strong math skills
  • Understanding of payer structures and coordination of benefits between payers
  • Ability to make appropriate and autonomous judgments and decisions on a variety of problems which require research, analysis and communication
  • Understanding structure of managed care contracts
  • Proficient in Microsoft Office suite

What you will do:

• Process patient credit/refunds in a timely manner per department policy
• Review and analyze the history of the assigned accounts (and associated accounts) to determine reason for credit balance on account and to assist in determination of appropriate action
• Maintain professional and positive contacts with other departments within the organization in order to obtain critical information required for account resolution
• Review and analyze the history of the assigned accounts (and associated accounts) to determine reason for payment variance on account and to assist in determination of appropriate action
• Maintain relationships with insurance payers in order to expedite resolution
• Use specific knowledge of managed care contract terms to validate calculation of payment variance. Use knowledge of contracts to communicate issue of payment variance (underpayments) to Managed Care Contracting team.
• Clearly and concisely document account with all actions taken and status per departmental procedures
• If trends are identified, gather information as to volumes and scope, which can then be presented to management, contracting, or other appropriate departments for review.
• Retrieve refund letters from QCI work queue. Process refund if request is appropriate. If request is not appropriate, notify insurance carrier per departmental policy

NorthShore University HealthSystem (NorthShore) is an integrated healthcare delivery system consistently ranked a Top 15 Major Teaching Hospital in the U.S. Headquartered in Evanston, Illinois, NorthShore comprises five hospitals (Evanston, Glenbrook, Highland Park, Skokie and Swedish), 140 Medical Group and Specialty Care offices, and more than 3,000 physicians, serving over 635,000 patients. The organization supports academics and research as the principal teaching affiliate for the University of Chicago Pritzker School of Medicine. Recognized for nursing excellence, NorthShore is a Magnet designated organization--the first system in Illinois to receive this prestigious honor. NorthShore has an established reputation and employs over 12,500 people.
When you work for NorthShore, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website (www.northshore.org) to better understand how NorthShore delivers on its mission "to preserve and improve human life" through superior clinical care, academic excellence and innovative research.
NorthShore is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National