Reimbursement Specialist Job Listing at HCSC in Chicago, IL (Job ID R0028034)

Description

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is  invested in your future!

Job Summary This position is responsible for translating contractual language/provisions into configurable reimbursement terms in the Enterprise Discounting application for Commercial lines of business (current and future) to ensure Blue Cross of Illinois network facilities receive accurate and timely contractual payments and allowances (i.e. discounts). Also responsible for auditing, claim testing, generating and validating monthly ad-hoc reports for both internal and external customers.

Required Job Qualifications:   

* Bachelor Degree in Finance, Accounting, Math or Health Care and 2 years managed care / financial analysis experience, OR 6 years managed care / financial analysis experience.

* Verbal and written communication skills.

PC proficiency inclusive of spreadsheet/database software including Excel and Access.

Preferred Job Qualifications:
* Experience with software language such as SQL, SAS and SPSS.
* Knowledge of hospital and institutional provider billing, payment methodologies, and managed care contracts.

* Experience working for a Managed Care Organization in Provider Data Operations, Network Management Contracting, or Provider Relations to include knowledge of business processes that impact facility/ancillary contract loading and auditing or 4 + years pricing configuration experience with ancillary and hospital contracts (Medicare or Commercial plans) including claims testing and auditing

*This is a hybrid role requiring 3 days in the office and 2 days remote weekly.

We encourage people of all backgrounds and experiences to apply. Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.

#LI-Hybrid

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Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

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