We Are Hiring!

At Riverside, everyday brings new and exciting challenges. You can expect an interesting environment where you’re part of making sure our organization is running optimally and safely, helping keep the community healthy. We provide the kind of paid training and opportunities that long-term careers are built on and we recognize hard workers who strive to make a difference. You will be able to succeed in our close-knit, safety-focused culture working together as a team. The careers we offer are meaningful because the work we do matters. Join us!

FTE: 1.000000

Shift: Days

Work Hours: M-F | 8:00am - 4:30pm | No Weekends | No Holidays

Location: PEOTONE HOME HEALTH CARE

 

Summary:

The Billing and Revenue Representative is responsible for the ensuring the billing, collection, and financial activities within Home Healthcare, Home Infusion and Skilled Nursing Facility (SNF) collaborating with the Billing Manager under the direction of the facility director. This representative is to ensure comprehensive and accurate collection and documentation of information during intake/registration to ensure compliance with applicable regulations as well as organizational policy.

Experience/Education Requirements:

High School diploma or equivalentHealthcare billing and registration experience preferredExcellent guest relation skills, including verbal and writtenMedical terminology desirablePrevious Home Health billing (HMO, PPO) experience with knowledge of Medicare and Medicaid billing regulations, Florida shared system desirable.Previous SNF billing experience with knowledge of Point Click Care experience preferred

License or Certification Requirements:

None

 

Responsibilities:

Aids in the development of procedures related to billing functions, licensure, and regulatory compliance.Answers and screens incoming calls to the department, with the appropriate disposition of the call performed with minimal assistance.Audits all patient account balances with the AOB to determine if accurate payment was received.Checks Passport and MEDI for claim status or calls insurance company on accounts that are determined by the agency that require follow-up.Completes statistical reporting, records, insurance forms, and assigned paperwork.Ensures that clerical, data entry information and billing activities are accurate in accordance with regulations and policy.Knowledge of Medicaid/Medicare billing requirements as defined by contract, state or federal law.Assist to maintain education of staff and knowledge of all regulations, as related to Medicaid.Responsible for all Medicaid prior approvals through the MEDI system.Performs billing activities in a timely manner in accordance with organizational policy.Performs insurance verifications, authorizations, and billing corrections in appropriate application.Reports problems to Coordinator prior to the end of the month to support A/R if goals are not met or delays in A/R increase.Responsible for all accounting functions, including deposits, input, and balance reconciliationsReview and audits insurance and self-pay A/R reports to identify accounts that have not been paid and seeks resolution in a timely manner.Review Kankakee Public Record Bulletin for petitions and bankruptcies monthly to determine if any Home Care accounts need to be withdrawn from collections and apply a charity adjustment.Seeks timely resolution of all outstanding accounts; begins appropriate appeal process as warrantedSends medical records to the insurance company when requested to be reimbursed for services.Sends series of invoices to patients that have a self-pay balance or makes a phone call, if determined necessary by the agency policy.Acts as Home Health Remote Patient Monitoring (RPM) LiaisonCoverage of Department Secretary responsibilities as it relates to medical records, supplies, and other respective responsibilitiesManage EPIC work ques as it relates to billing, registration, intake, and MSPQCoordinates submission of PBJ to CMS and other time sensitive reporting to HFS or IDPH as requiredConsistently maintains the assigned private pay (self pay) accounts receivable> 120 days at 15% or lessSupports IDT as r/t pt coverages, information, update of financial status in eMAR carve out or consolidated billingResolve private pay (self pay) accounts within 120 days of final bill date

 

 

Education:
Essential:
* HIGH SCHOOL DIPLOMA

 

Riverside Healthcare is revolutionizing care using leading-edge technology to diagnose and treat patients. We are ranked top in the nation for performance in neurosurgery, orthopedics, and heart surgery and have also been named one of the nation's 100 Top Hospitals by Truven Health Analytics seven times. Riverside is nationally recognized for our specialty programs in obstetrics, trauma, oncology, rehabilitation, geriatrics, occupational health, psychiatric services, and treatment of alcohol and chemical dependency, as well as patient safety. We combine innovation and convenience at state-of-the-art facilities located in communities throughout the greater Kankakee area.

Riverside Medical Center proves that truly progressive medicine is being delivered in Chicago's southwest suburbs and East Central Illinois. Join a team that is not only concerned with providing the best care possible but also with offering a work environment of advancement and growth. Riverside is a place that embraces a culture where opinions count and dedications is respected, where superior performance is rewarded with competitive salaries and excellent benefits.

 

Other information:

Exposure/Sensory Requirements

 

Exposure to:
Chemicals: None
Video Display Terminals: Average
Blood and Body Fluids: None
TB or Airborne Pathogens: None

Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Command of English language, good speaking for verbal communication with public and employees.
Vision: Required to see computer screens, papers, fax, printer, written materials.
Smell:
Hearing: Must be able to hear for verbal and telephone communication.
Touch: Computer, telephone, handwriting

Activity/Lifting Requirements

 

Average Hours per Week: 40

Shift: Days

Percentage of time during the normal workday the employee is required to:
Sit: 75%
Twist: 0%
Stand: 10%
Crawl: 0%
Walk: 5%
Kneel: 2%
Lift: 1%
Drive: 0%
Squat: 2%
Climb: 0%
Bend: 3%
Reach above shoulders: 2%

The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Continuously
Up to 20 lbs: Occasionally
Up to 35 lbs: Occasionally
Up to 50 lbs: Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
> Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 360
Twist: 0
Stand: 30
Crawl: 0
Walk: 10
Kneel: 1
Lift: 5
Drive: 0
Squat: 5
Climb: 0
Bend: 5
Reach above shoulders: 5

Repetitive use of hands (Frequency indicated):
Simple grasp up to 10 lbs. Normal weight: 5# continuously
Pushing & pulling Normal weight:
Fine Manipulation: Telephone, sorting papers, computer entry, writing, using fax, printers, typing.

Repetitive use of foot or feet in operating machine control:

Environmental Factors & Special Hazards

 

Environmental Factors (Time Spent):
Inside hours: 8
Outside hours :

Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere:

Special Hazards:
Protective Clothing Required:

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