No Surprises Act Coordinator

Education:

Associate's Degree or Experience In Lieu of Education

• Accountable to work and manages designated Epic WQ's and reports to identify and verify non-contracted coverage assignments
• Negotiates by providing supporting documentation for out-of-network single case agreements and open negotiations
• Reviews and evaluates proposed agreements and contracts to ensure they align with Carle Health's needs and interests.
• Creates and maintains records of negotiations and agreements for future reference.
• Confirms patient insurance eligibility and in-network status before services are rendered (if applicable).
• Ensures accurate billing codes are used to prevent unnecessary billing issues and potential surprise bills.
• Initiates and manages the IDR process when a billing disagreement occurs between the provider and insurance company.
• Strong communication skills: Effective communication with patients, insurance companies, and internal departments to resolve billing issue
• Stays updated on NSA regulations and ensuring the healthcare facility adheres to all compliance requirements.
• Stays updated on healthcare billing regulations and ensures adherence to HIPAA privacy standards
• Tracks and analyzes billing data to identify trends and potential areas for improvement related to surprise billing.

Find it here.

Discover the job, the career, the purpose you were meant for. The supportive and inclusive team where you can thrive. The place where growth meets balance - and opportunities meet flexibility. Find it all at Carle Health.

Based in Urbana, IL, Carle Health is a healthcare system with nearly 16,600 team members in its eight hospitals, physician groups and a variety of healthcare businesses. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet designations, the nation's highest honor for nursing care. The system includes Methodist College and Carle Illinois College of Medicine, the world's first engineering-based medical school, and Health Alliance. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.