Ann & Robert H. Lurie Children’s 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 Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

Day (United States of America)

Location

Ann & Robert H. Lurie Children's Hospital of Chicago

Job Description

This position contributes and supports revenue integrity’s role to strengthening the interface between clinical departments, patient financial services and professional billing, along with contributing to a continual process to ensure accurate charge capture and accurate reimbursement. 

Essential Job Functions:

Tracks audits from internal and external sources including, but not limited, to RAC, PERM, DRG, and other charge audits.Reviews denials relating to charge capture, Correct Coding Edits (CCI), Medical Unlikely edits (MUE), and other clinical based denials and monitors for trends. Works with patient financial services to improve and monitor denials, works with appropriate staff as necessary to reduce denials and rework. Appeals with appropriate regulation or literature and works with payers on recurring concerns. Develops procedures for the Revenue Cycle partners to process denials, including education the development of situation specific letters or protocols for staff to use when challenging denials. Manages software and processes to improve revenue capture. Identifies improvement opportunities and implements rules to protect revenue. Works with clinical teams to ensure all appropriate revenue is captured. Reviews professional components of charge capture is consistent and compliant with technical portion when applicable. Ability to work with and interpret detailed medical record documents and communicate effectively with physicians, nursing staff, leadership and other billing personnel. Collaborates with clinical leadership, Information Management and other internal and external entities regarding deficiencies and opportunities observed.Provides recommendations for improvement for charge capture and provides education as necessary. Performs follow up review to ensure implementation of improvements. Collaborates with Revenue Cycle and Compliance leadership to assist with development of the annual Revenue Integrity Workplan. Ensures implementation of work plan. Assists in the coordination and management of the Denials Task Force. Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others. Other job functions as assigned.

Knowledge, Skills & Abilities:

Bachelor’s degree required; master’s degree preferred. Registered Nurse licensure required.5+ years of acute care or medical office experience required, Knowledge of CPT and ICD10CM, Coding credential preferred.Strong analytical and financial skills Proficient with Microsoft Office: Excel, Word and Power Point.Ability to lead and work cross functionally with other departments.Strong verbal and written communication skills required. Has working knowledge of clinical operations in a complex academic environment. Solid understanding of medical terminology, anatomy and physiology along with hospital activities.Strong research skills and the ability to understand and interpret billing and documentation regulations.Understand Medicaid and Medicare billing regulations. Ability to work independently and creatively and objectively. Comfortable with using computers including the EMR. Epic experience preferred.Healthcare billing knowledge required.

Education

Bachelor's Degree: Finance (Required)

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 Children’s facilities

Discount purchasing program

There’s a Place for You with Us

At Lurie Children’s we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints — recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship. 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 Children’s and its affiliates are equal employment opportunity employers.  We value diversity and are committed to creating an inclusive environment for all employees.  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.

Support email: candidatesupport@luriechildrens.org