Department:
38518 Carolina CARE Pharmacy - CarolinaCARE
Status:
Full time
Benefits Eligible:
Yes
Hours Per Week:
40
Schedule Details/Additional Information:
Monday to Friday 8 am to 5 pm
Pay Range:
$22.90 - $34.35
Essential Functions
- Direct patient/provider interaction
- formulary review, cost optimization, etc.
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Coordinates and manages the billing and collection functions for all payor types.
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Notifies physician offices of contract periods, identifies and monitors accounts, determines correct reimbursement, bundles all bills for submittal to insurance companies, rebills claims as necessary, followings up on claim status, performs regular account maintenance, collects and distributes payments appropriately.
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Researches insurance benefits, options and potential patient financial needs and discusses findings with patients and their families.
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Develops a financial plan with patients and their families.
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Works with patients and develops resolutions to potential patient financial out-of-pocket exposure and helps them plan and overcome these obstacles.
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Obtains all necessary payer authorizations.
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Verifies and monitors coverage and other medical benefits and acquires necessary referrals and authorizations.
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Ensures that all payor approvals are current at all times.
Physical Requirements
Mobility required. Majority of the day spent sitting. Must be able to lift up to 5 lbs of patient charts. Work requires stretching to file or retrieve charts or manuals. Must be able to communicate with other groups and departments.
Education, Experience and Certifications
Bachelor's Degree in Accounting, Finance or related field or 5 years of insurance related experience required. 1 to 2 years of reimbursement experience in a hospital setting is preferred. Must be able to work independently and possess strong organizational, time management and interpersonal skills and be able to prepare and analyze financial reports. Must be proficient with medical terminology and be familiar with clinical considerations as these relate to transplant cases. Extensive analytical skills and focus on details. Excellent written and oral communication skills required. Microsoft Excel, Word, STAR and IDX experience required. Databases, hospital registration, billing and clinical systems preferred.
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Benefits and more
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Performs duties of moderate complexity, judgement, and scope in coordinating and managing all aspects related to insurance benefit information, authorization, billing and collections for all types of services. Will serve as a resource to patients and their families, clinical staff, physicians and insurance companies.
