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Job Description

Reimbursement Specialist Revenue Cycle Analyst
Date: 11/06/2009
Location: Des Plaines, IL
Facility:ADVOCATE HEALTH CENTERS
Reimbursement Specialist Revenue Cycle Analyst - 28235 		Apply Now
Location: 701 Lee Street; Des Plaines, IL

* Strong computer skills, especially use of spreadsheet (Excel) and database management (Access) software
* Ability to organize and manage multiple tasks to reach deadlines
* Good analytical skills, including ability to analyze and work with large volumes of data and draw valid conclusions and develop accurate reports
* Solid understanding of CPT coding and work RVUs
* Solid understanding of ICD-9, HCPCs,LMRP, CPT Codes, MRA,Rejection Codes, Paycodes.
* Good communication skills
* Excellent work attitude and ability to work with others
* Bachelor's Degree Required
* Ten or more years of experience in physician medical group coding reimbursement position
* CCSP preferred

Job Description:

This position requires an honest, ethical, and positive approach to reimbursement for the Advocate Health Centers. This position is responsible for the optimization of the following areas of reimbursement management: Insurance Denials, Rejections, Payments, EOB, IDX Edits, Ecommerce Rejections and Edits, Coding and Billing knowledge and experience, A/R Coding and Billing Research.

The Reimbursement Specialist position requires an ability to identify denials through an analysis of root causes for historical denials and can proactively take action steps utilizing a preventative approach to correcting errors. This position would also require reimbursement knowledge of HCPCS, Pay Codes, Rejection Codes, LMRP, ICD-9 and CPT Coding, as well as rejection reason communication, contacting, partnering, researching, and educating various internal and external customers, i.e. Business Office associates, management, physicians/providers, health centers, patients, coding dept., credentialing dept., contracting, facilities, and insurance payers.

Identifying areas for improvement, implementing processes and flows to prevent repetitive errors and being proactive in identifying appropriate education and automated techniques, processes and flows to allow for maximum insurance reimbursement. This position requires an analytical and critical mind that can effectively communicate education at multi-levels of knowledge and expertise.
Accountabilities:
1. Revenue Cycle Management: The position is responsible for the optimization of the following areas of revenue cycle management.

2. Use of Automated Systems for Analytical Review of Root Causes: The position is responsible for the root cause analysis for historical data, utilizing rejections and edits in a preventative approach to correcting errors in one or more of the following systems:

3. Payment Accuracy:

4. Other Shared Responsibilities:
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