Rejection and Denial Representative

Join the Evanston Northwestern Healthcare (ENH) Hospital Business Office.  Our Hospital Business Office is comprised of the following areas where growth opportunities are abundant: Customer Service, Insurance Follow-up, Rejections & Denials, Correspondence units and Coding and Billing operations.

We are leaders in innovation and technology and our team is an integral part of the ENH Revenue Cycle.  The Hospital Business Office will begin using Epic in early 2009, which will allow our employees to be more effective in their jobs.  Our employees focus on one area of responsibility versus the entire lifecycle of a bill to maximize work efficiencies.  This allows each unit to work cohesively with one another.

We strongly believe that our reputation as a premier healthcare system depends upon those who invest their careers with us.  For our mission--to preserve and improve human life-- a work environment that retains happy, satisfied employees is essential. 

We have immediate openings and are currently seeking a Rejection and Denial Representative for our Hospital Business Office.  This position is located in Skokie, convenient to Metra and CTA transportation.

The purpose of this job is to work and resolve all denied and underpaid insurance claims on hospital accounts to assure receipts of all entitles reimbursement.

In this role, you will:

*Perform timely follow up activities on assigned denied and underpaid insurance claims
*Effectively utilize system work queue to review and prioritize assigned accounts
*Identify reason for denial or underpayment and perform the next step in appeal process to obtain additional payment
*Work with the department lead on resolving issues when necessary
*Appropriately involve patient /guarantor when required to assist in obtaining insurance payment/resolution an account
*Maintain relationships with insurance payers in order to expedite payment resolution
*Follow up on all levels of appeals
*Comply with all federal and state regulations in regard to collection of debts
*Provide assistance to other team members
*Perform other duties as assigned

 

 

 

Our ideal candidate will meet the following requirements:

*High school diploma or equivalent required; two years post high school education or degree preferred

*One year of general office experience required

*Minimum two years of experience in a healthcare financial setting required

*Must be an effective communicator as demonstrated through professional written and verbal skills

*Computer keyboarding,10-key and mouse proficiency required

*Must be familiar with PC applications in a Windows environment; knowledge of MS Word and Excel preferred

*Ability to build positive working relationships outside the immediate work group

*Ability to evaluate and prioritize workload

*Ability to quickly problem-solve and identify appropriate issues for escalation to management

*A high analytical ability is required to comprehend, interpret, and explain complex contract terms

*Must be able to demonstrate critical thinking skills to determine root causes on reimbursement issues

*Strong math skills

*Knowledge of CPT coding practices preferred 

 

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Evanston Northwestern Healthcare is a 3-hospital healthcare system located in the northern Chicago suburbs, along the shores of beautiful Lake Michigan.  Recently named a Most Wired Hospital**, our commitment to technology drives the way we practice medicine. 

 

As part of our organization, you’ll find competitive salaries, comprehensive benefits, 2 retirement plans (a 403B & an employer-funded pension) & a generous vacation package.  Our tuition reimbursement program & extensive training curriculum make it an ideal place for continued learning. 

To find out more about life at ENH or to apply for this position, please vist our Careers Web site at www.enh.org/careers  

AA/EOE

 

**Hospitals & Health Networks