Account Service Representative II – Claim Follow-Up Representative

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.

Location

680 Lake Shore Drive

Job Description

Schedule: Hybrid

The Account Service Representative II – Claim Follow-Up Representative is responsible for managing claim follow-up activities to ensure timely reimbursement for professional services. This role includes investigating and resolving unpaid or denied claims, working payer correspondence, and collaborating with internal departments and payers to secure proper claim resolution. The representative will work within the Epic system to monitor accounts receivable and take necessary actions to reduce aged AR.

Key Responsibilities:

• Conduct timely and thorough follow-up on outstanding professional billing claims using Epic workqueues.
• Research and resolve denied, delayed, or unpaid claims by communicating with payers via phone, portal, or written correspondence.
• Review payer responses and denial codes to determine appropriate action for claim resolution.
• Coordinate with coding, registration, and clinical departments to correct claim errors and resubmit when appropriate.
• Document all activities and communications clearly in the Epic system to maintain accurate account records.
• Identify and escalate trends or payer issues to management for resolution and payer intervention.
• Maintain knowledge of payer-specific guidelines and billing regulations.
• Meet or exceed productivity and quality metrics established by the department.
• Assist with training and mentoring of new staff as needed.

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

$21.00-$32.55 Hourly

At Lurie Children’s, 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 Children’s offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link 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