Reimbursement Officer, Payment Determination & ...

Job Requisition ID: 47351 Closing Date: 07/02/2025 "‹Agency: Department of Children and Family Services Class Title: REIMBURSEMENT OFFICER I - 38199 Skill Option: None Bilingual Option: None Salary: Anticipating Starting Salary (Effective 7/1/25) $4954 Step 1B/month; Full Range $4954 - $6894 Job Type: Salaried Category: Full Time County: Sangamon Number of Vacancies: 1 Bargaining Unit Code: RC062 Merit Comp Code: This position is a union position; therefore, provisions of the relevant collective bargaining agreement/labor contract apply to the filling of this position. All applicants who want to be considered for this position MUST apply electronically through the illinois.jobs2web.com website. State of Illinois employees should click the link near the top left to apply through the SuccessFactors employee career portal. Applications submitted via email or any paper manner (mail, fax, hand delivery) will not be considered. Why Work for Illinois? Working with the State of Illinois is a testament to the values of compassion, equity, and dedication that define our state. Whether you're helping to improve schools, protect our natural resources, or support families in need, you're part of something bigger"”something that touches the lives of every person who calls Illinois home. No matter what state career you're looking for, we offer jobs that fit your life and your schedule"”flexible jobs that provide the gold standard of benefits. Our employees can take advantage of various avenues to advance their careers and realize their dreams. Our top-tier benefits and great retirement packages can help you build a rewarding career and lasting future with the State of Illinois. Position Overview The Illinois Department of Children and Family Services is seeking an organized, professional, and results oriented individual to serve as Reimbursement Officer for Payment Determination and Reconciliation. Under general supervision, this position will perform a variety of professional reimbursement duties involved in the maintenance of the complex board payment system for the Department. The position will investigate and evaluate DCFS payment amounts from various reports, in compliance with rules established by the Department. This position will also independently research and analyze discrepancies in daily transactions and analyze field and provider inquiries related to eligible board payments for relative/traditional children. This position provides a great opportunity for a motivated, detail-oriented individual who is interested in playing a role in the reimbursement process for the Department of Children and Family Services. DCFS offers a competitive compensation plan, excellent benefits, and a pension program. The ideal candidate for this position will have excellent organizational skills and communications skills. We invite you to join our innovative team to help make a positive difference in the lives of the children and families of Illinois Essential Functions Serves as Reimbursement Officer for Payment Determination and Reconciliation Independently researches and analyzes discrepancies in daily transactions Investigates and analyzes field and provider inquiries related to eligible board payments for relative/traditional children Investigates and analyzes information necessary to determine eligible payments for relative/traditional children, including AFDC eligibility status, movement of DCFS and non-DCFS children into and out of a home, provider social security number changes and verification, licensing status changes and verification, and changes in the approval status regarding specialized foster care Conducts investigations to complete placement/payment authorization information to procure relevant information needed to change the DCFS provider ID number with which children are associated based on data in the cluster database and licensing screens Audits claim vouchers to ensure compliance with rules and regulations promulgated by statute as well as internal policies, procedures, and contractual agreements Serves as liaison with private agencies, relative caregivers, DHFS and other agencies, central office licensing staff, central and regional office contract staff, and other appropriate entities with regard to board errors, methods of correction, and interpretation of rules and regulations established by the Department, providing instruction as needed Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above Minimum Qualifications Requires knowledge, skill, and mental development equivalent to completion of four years of college with courses in accounting, economics, or business administration, preferably including courses in insurance, estate, and probate law Requires one year of work experience in the reimbursement field Conditions of Employment Requires ability to pass a background check. The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description About the Agency DCFS is deeply committed to the welfare and protection of children. Our goal is to protect children by strengthening and supporting families. In every effort, from receiving hotline calls to reaching family reunification or foster care and adoption, children and families are our focus. The Division of Budget and Finance plays a supporting role in the Department's operations by working to ensure the agency's financial stability and implementation of sound budgetary practices. Work Hours: Monday - Friday 8:30am - 5:00pm Work Location: 406 E Monroe St, Springfield, Illinois, 62701 Agency Contact: Fisayo Oyadeyi Email: Posting Group: Fiscal, Finance & Procurement; Social Services This position DOES NOT contain "Specialized Skills" (as that term is used in CBAs).Oversee the audit of clinician charts to assess compliance of standardized documentation guidelinesTake initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely mannerMaximize performance by suggestion appropriate process improvements and identify/address issues that delay or prevent patient access to therapyOversee the Cash Application functionConfirm coverage, schedules and management of employee vacationsAssist in the filing of the RHCF4, Medicare nursing home cost reports and any other type of cost reportMaintain a network of key thought leaders to effectively assist with payer strategies including e.g.specialty societies, key accounts, key customersImprove and implement positive change in the reimbursement functionLeading a national team of Field Reimbursement Associate Directors tasked with providing appropriate and accurate managed care coverage and reimbursement policy information regarding products to providers and for the benefitSupporting analysis processes to plan activity and maintain account recordsAssimilate a smooth and standard workflowOversee the functions of the Billing Group(s) of an assigned geography to ensure successful management of the receivables and effective and efficient function of the revenue cycleMaintain working knowledge of the current billing office system and perform ongoing training to collections staffIdentify, develop, and manage relevant state/regional trade association relationshipsComplete all administrative responsibilities in a timely fashion as directed by managementParticipate in special projects and perform other dutiesDevelop net revenue models to estimate proposed Governmental regulatory changes which effect hospital reimbursementEnsure all activities are consistent with all regulations, laws and company compliance policiesReport to the CEO and is responsible for leading the team and driving the strategies for collecting payment from patients, insurance companies and government health programsManage the implementation of key strategies through the management team

Created: 2025-06-05