
10,000+ employees
Founded 1946
⚕️ Healthcare Insurance
🏥 Healthcare
📚 Education
Healthcare Insurance • Healthcare • Education
Carle Health is a comprehensive healthcare provider dedicated to managing the health needs of its community. Offering a wide range of services, from general medical care to specialized treatments in oncology, cardiovascular, pediatrics, and women's health, Carle Health emphasizes quality patient care and community health initiatives. Additionally, it supports education and research through the Carle Illinois College of Medicine and engages in community health programs that aim to improve overall well-being.
🔥 0 minutes ago
🌽 Illinois – Remote
💵 $17 - $27 / hour
⏰ Full Time
🟡 Mid-level
🟠 Senior
💰 Accounts Receivable
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👻 Ghost score 0%
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10,000+ employees
Founded 1946
⚕️ Healthcare Insurance
🏥 Healthcare
📚 Education
Healthcare Insurance • Healthcare • Education
Carle Health is a comprehensive healthcare provider dedicated to managing the health needs of its community. Offering a wide range of services, from general medical care to specialized treatments in oncology, cardiovascular, pediatrics, and women's health, Carle Health emphasizes quality patient care and community health initiatives. Additionally, it supports education and research through the Carle Illinois College of Medicine and engages in community health programs that aim to improve overall well-being.
• Manage accounts receivable in compliance with regulatory, billing, and payer guidelines • Collect outstanding receivables through payer portals and phone lines • Validate coverage and accurately bill insurance claims • Resolve charge review edits, claim edits, clearinghouse rejections, and payer rejections • Follow up on outstanding receivables and complete basic appeals • Answer, document, and complete inquiries from insurance companies, internal departments, and third-party payers • Collaborate with Billing, Coding, Cash Posting, and other departments to ensure claims are processed and paid correctly • Monitor, research, and resolve unpaid, rejected, denied, and allowance-discrepancy claims • Document collection activities accurately in the billing system • Research medical documentation, eligibility, billing guidelines, referrals, and authorizations using clinical applications and payer websites • Review undistributed payments and apply them to open balances • Review and resolve incoming correspondence • Identify and request account adjustments • Resolve insurance setup errors to facilitate timely billing • Evaluate credit/balance accounts and process refunds or payer recoupments • Prepare appeals, corrected bills, adjusted accounts receivable entries, and refunds • Answer calls through a department rotation line and direct callers as needed • Perform other duties as assigned
• Must have HB, PB, and denials experience • Ability to take initiative, accept direction, and seek guidance appropriately • Ability to manage confidential information sensitively and discreetly in a HIPAA-compliant way • Strong problem-solving and critical-thinking skills • Ability to submit accurate electronic and paper insurance claims • Ability to submit non-complex reconsiderations and appeals via paper, fax, or web portal • Ability to monitor, research, and resolve unpaid, rejected, denied, and allowance-discrepancy claims • Ability to analyze accounts and determine appropriate resolution actions • Ability to use clinical applications, payer websites, and other systems to retrieve medical documentation, eligibility information, billing guidelines, referrals, and authorizations • Ability to resolve insurance setup errors, charge review edits, claim edits, clearinghouse rejections, and payer rejections • Ability to evaluate credit/balance accounts and process refunds or payer recoupments • Ability to prepare appeals, corrected bills, account adjustments, and refunds according to procedures • Ability to answer department calls and direct callers appropriately
• Comprehensive benefits package • Equal Opportunity Employer • Potential for growth and life-long careers
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