Wheaton Franciscan Healthcare

Payor Services Representative

Location: West Allis, WI

Performs follow-up functions to ensure maximum physican reimbursement is obtained on all third-party payor claims from either a proactive or a reactive approach. Responsible for accurate and complete patient accounts based on departmental protocol, policies and procedures. Position researches contested claims and determines appropriate payment based on services performed and contract terms in effect. Recommends and appeals and / or requests additonal payments and/or recoupments from payor as needed. position will document and communicate findings to appropriate payor organization within a timely manner. Updates and corrects the billing system to reflect the proper insurance status of the patient. Provides timely and effective customer service to internal and external interested parties.

Skills/Requirements

Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers and supervisors. Must be able to understand and comply with policies and procedures. High school diploma or GED equilvent required