Claims Follow-up Insurance Specialist - Government
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What you'll do
- 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.
What they're looking for
- High school diploma or GED required.
- Minimum of 2 years of experience in professional billing follow-up or healthcare revenue cycle operations, preferably in a professional billing environment.
- High School Diploma/GED (Required)
Nice to have
- Associate’s or Bachelor’s degree in healthcare, business, or related field preferred.
- Strong working knowledge of Epic EHR is preferred.
- Experience with medical insurance guidelines, CPT/ICD-10 codes, and denial management is preferred.
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
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
Job Description
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.
Qualifications:
Education:
High school diploma or GED required.
Associate’s or Bachelor’s degree in healthcare, business, or related field preferred.
Experience:
Minimum of 2 years of experience in professional billing follow-up or healthcare revenue cycle operations, preferably in a professional billing environment.
Strong working knowledge of Epic EHR is preferred.
Experience with medical insurance guidelines, CPT/ICD-10 codes, and denial management is preferred.
Skills and Abilities:
Strong problem-solving and analytical skills.
Excellent verbal and written communication skills.
Ability to navigate payer websites and systems for claim status and resolution.
Proficiency in Microsoft Office applications (Excel, Word, Outlook).
Ability to manage time effectively and work independently in a fast-paced environment.
Understanding of HIPAA and patient confidentiality requirements.
Education
High School Diploma/GED (Required)Pay Range
$21.00-$32.55 HourlyAt 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
- 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 Ann & Robert H. Lurie Children’s Hospital of Chicago and its affiliates (collectively “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.
For questions about how to request an accommodation please contact: employeehealth@luriechildrens.org
AI Notice
Lurie Children’s utilizes certain AI-enabled features within our recruiting platform to support candidate engagement and assist recruiters in identifying and prioritizing applicants whose experience aligns with job requirements. All employment decisions are made by individuals.
It is a civil rights violation with respect to recruitment, hiring, promotion, or employment for an employer to use artificial intelligence that has the effect of subjecting employees to discrimination on the basis of protected classes under the Illinois Human Rights Act or to use zip codes as a proxy for protected classes.
For questions about the use of artificial intelligence in this process or any additional support, please contact: peoplequestions@luriechildrens.org
Company
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