Account Service Representative I â Claim Edit Representative
Account Service Representative I â Claim Edit Representative
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Job Description
Ann & Robert H. Lurie Childrens Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence kids and their families are at the center of all we do. Ann & Robert H. Lurie Childrens Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.
Location
Job Description
Schedule: Hybrid
The Account Service Representative I Claim Edit Representative is responsible for reviewing analyzing and resolving claim edits within the Epic work queue system to ensure timely and accurate claim submission for professional services. This role plays a vital part in the revenue cycle by identifying and correcting billing errors coordinating with internal departments to resolve coding and registration issues and maintaining compliance with payer and regulatory requirements.
Key Responsibilities:
- Review and resolve professional billing claim edits and charge review work queues in Epic.
- Ensure claims comply with payer-specific billing guidelines and regulations.
- Communicate and collaborate with coding registration and clinical departments to resolve claim errors or missing information.
- Identify recurring issues and escalate trends to management for process improvement and payer escalation.
- Utilize Epics real-time eligibility and payer tools to validate insurance data and benefits.
- Work denials related to claim edits when necessary ensuring proper documentation and timely follow-up.
- Maintain documentation of all actions taken on accounts in accordance with department policies.
- Assist in maintaining edit resolution workflows and reference materials.
- Stay up to date on billing regulations payer guidelines and Epic system updates.
- Meet productivity and quality standards as defined by department leadership.
Education and Skills:
- High school graduate required; physician or hospital billing experience and/or training BS or BA preferred.
- Knowledge of ICD-10 coding medical terminology third party billing and collections required.
- EPIC experience preferred.
- Excellent communication and listening skills
- Problem solving ability and able to handle multiple priorities.
- Knowledge of windows-based personal computers is required and experience with electronic claims editing software preferred.
- Demonstrates effective utilization of the features of the telephone system in order to achieve greater productivity with appropriate collection practices and techniques.
- Thorough knowledge of patient accounting third party payer procedures governmental regulations and managed care contracting to be effectively proactive in the billing and collection process and to respond to inquiries on patient accounts in a customer satisfaction manner.
Education
High School Diploma/GED (Required)Pay Range
$19.50-$30.23 HourlyAt Lurie Childrens we are committed to competitive and fair compensation aligned with market rates and internal equity reflecting individual contributions experience and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions.In addition to base salary Lurie Childrens offer a comprehensive rewards package that may include differentials for some hourly employees leadership incentivesfor select roles health and retirement benefits and wellbeing programs. For more details on other compensation consult your recruiter or click the followinglink to learn more about our benefits.
Benefit Statement
For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:
Medical dental and vision insurance
Employer paid group term life and disability
Employer contribution toward Health Savings Account
Flexible Spending Accounts
Paid Time Off (PTO) Paid Holidays and Paid Parental Leave
403(b) with a 5% employer match
Various voluntary benefits:
Supplemental Life AD&D and Disability
Critical Illness Accident and Hospital Indemnity coverage
Tuition assistance
Student loan servicing and support
Adoption benefits
Backup Childcare and Eldercare
Employee Assistance Program and other specialized behavioral health services and resources for employees and family members
Discount on services at Lurie Childrens facilities
Discount purchasing program
Theres a Place for You with Us
At Lurie Childrens we embrace and celebrate building a team with a variety of backgrounds skills and viewpoints recognizing that different life experiences strengthen our workplace and the care we provide to the Chicago community and beyond. We treat everyone fairly appreciate differences and make meaningful connections that foster belonging. This is a place where you can be your best so we can give our best to the patients and families who trust us with their care.
Lurie Childrens and its affiliatesare equal employment opportunity employers. All qualified applicants will receive consideration for employment without regard to race color sex sexual orientation gender identity or expression religion national origin ancestry age disability marital status pregnancy protected veteran status order of protection status protected genetic information or any other characteristic protected by law.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
