Claims Processor - Located in Rockford, IL

About Us:

Leaders in recovery. Champions of hope.

Rosecrance is a private not-for-profit organization and nationally recognized leader in treating substance use and mental health disorders for children, adolescents, adults, and families. With nearly 60 locations in Illinois, Wisconsin, and Iowa, our physician-led team has developed an innovative, multidisciplinary, outcomes-informed approach.

Since 1916, our unmatched legacy as a proven behavioral healthcare leader is a source of hope and strength to those we serve and provides a roadmap for the best opportunity for lasting recovery. Rosecrance served nearly 50,000 clients last year.

Position Purpose:

Achieve accurate and timely submission of claims through audit and processing of client data as well as continuously improving revenue cycle processes.

Job Qualifications:

• High School diploma or GED
• Minimum of five years’ experience in healthcare claims processing, or combination of education, training and experience
• Computer proficiency in a Windows environment, knowledge of Microsoft Office products with an emphasis in Excel.
• Detailed knowledge of electronic billing processes and universal billing forms (UB04, HCFA 1500)
• Adequate written skills to accurately complete required documentation within the time frames prescribed
• Excellent organizational skills

Essential Responsibilities:

• Work an eight hour shift five days a week and be available to work additional hours when necessary. Overtime may be required. 
• Responsible for billing public revenue (Federal and State grants, DASA, Medicare, Medicaid, county, other public programs) and/or private revenue
• Tracking and reporting revenue cycle data for trends and issues
• Check status of claims through use of telephone, websites and/or other means available.
• Modify and document processes to meet changing requirements - troubleshoot process problems, propose solutions
• Maintain current knowledge of billing coding including CPT, HCPCS, Revenue codes & modifiers
• Identify and enter billing corrections into the electronic medical record
• Uphold integrity of accounts receivable ledger, including aged receivable monitoring on a monthly basis.
• Create journal entries as necessary.
• Enter cash receipts according to guidelines.
• Setup, testing and maintenance of program billing defaults and dictionaries within the electronic medical record. (e.g., billing codes, pricing, guarantors, and loop/segment data fields)
• Transfer data between electronic medical record and general ledger systems.
• Provide appropriate documentation and reports designed to assist in fiscal management of the agency.
• Serve as a member of the Revenue Cycle Team and participate in all team meetings and activities.
• Understand and comply with all of the principles established by the Rosecrance Corporate Compliance Program and Code of Ethics.
• Perform all responsibilities in compliance with the mission, vision, values and expectations of Rosecrance.
• Deliver exceptional customer service consistently to every customer.

Job Type: Full-time

Pay: Based on education, experience and credentials

Benefits:

• Health insurance with multiple options to meet your needs
• Flexible Spending Account
• Health Savings Account with company contribution
• Dental insurance
• Vision insurance
• 401(k) plan with employer match and discretionary employer contribution
• Group life Insurance including LTD and AD&D
• Tuition assistance (qualifications apply)
• Licensure/certification reimbursement (qualifications apply)
• Paid time off
• Referral program
• Wellness plan
• Certain facilities offering on-site gym

Schedule: 8 hour shifts

• Day shift: 8:30am - 5:00pm
• Monday - Friday

Work Location: Rosecrance Health Network - Rockford, IL

Rosecrance is an equal opportunity employer.

EEO is the Law: