CommonSpirit Health Billing & Patient Account Rep II - Physician Billing Office in DES MOINES, Iowa
MercyOne Central Iowa operates four not-for-profit, Catholic medical centers in Des Moines, West Des Moines, Newton and Centerville and two specialty hospitals – MercyOne Children’s Hospital in Des Moines and MercyOne Rehabilitation Hospital in Clive (965 beds total) – along with more than 20 additional facilities that house more than 50 primary care, pediatric, internal medicine and specialty clinics. Founded by the Sisters of Mercy in 1893, MercyOne Central Iowa has the longest continually operating hospital in Des Moines and is also one of the largest employers in the state, with more than 7,000 employees and a medical staff of more than 1,000 physicians and allied health associates. MercyOne Central Iowa is a member of MercyOne, which was founded in 1998 through a collaboration between CommonSpirit Health and Trinity Health – two of the country’s foremost, not-for-profit Catholic health organizations. MercyOne has more than 20,000 colleagues in Iowa and surrounding states.
Positions Available for our Physician Billing Office
We are looking to fill positions in the follow departments:
Billing (Billing Specialists)
Follow-up (Patient Account Rep II)
Customer Service (Patient Account Rep II)
Cash Posting (Patient Account Rep II)
SUMMARY OF DEPARTMENTS:
Maintains accounts receivable, accurately codes and posts charges
Assists with insurance denials for correction and re-filing. Appropriately corresponds with follow-up team via practice management system.
Appropriately uses ICD-10 and CPT-4 codes.
Resolve routine patient billing inquiries and problems, handling follow-up questions from customer service team, resolving discrepancies or errors.
Works unassigned payment queues and reports.
Maintains functional knowledge of insurance terminology and ensures the accuracy of registration data.
Keeps abreast of insurance carrier rules and changes by participating in carrier specific and MCI education opportunities
Perform other duties as assigned.
Patient Account Rep II
Responsible for reviewing accounts for correct third-party billing as assigned.
Contacts insurance carriers, patients, and clinics to resolve claim issues.
Updates patient registration and insurance as needed to correctly file claims.
Ability to process complex claim correction involving both pending and previously adjudicated claims.
Ability to utilize high level thinking and problem solving to bring complex claims to resolution.
Files claims according to insurance company guidelines.
Participates in recognizing denial trends and provides feedback to manager
Maintains claim and online notes
Assists walk-in patients
Handles patient complaints, de-escalates callers, provides appropriate solutions within time limits, and follows up to ensure resolution.
Identifies and assesses patients’ needs to achieve satisfaction.
Builds trust with patients using open and interactive communication.
Provides accurate, valid and complete information using the right methods and tools.
Meets personal and customer service team targets and call handling quotas.
Keeps records of patient interactions by noting accounts.
Follows communication procedures, guidelines and policies.
Responsible for the posting of all assigned cash payments, adjustments, and/or remark codes to the appropriate claim, service date and/or account from all EOB’s and ERA’s.
Possesses ability to comprehend complex insurance claims and explanations of benefits in various payer formats
Adheres to all cash posting processes and protocols
Contacts payers to resolve issues necessary in order to reconcile and apply payments
Reconciles each batch to the check deposit amount
Initiates the refund/recoup process for all credit balances
Maintains ability to recognize claim denials on EOB’s/ERA’s and applies information appropriately to allow for additional follow up as necessary
Brings all variances to resolution within established timeframes
Maintains productivity standards defined by management.
Ability to research errors that resulted in unposted claim payments.
Coordinate activities for unidentified payments.
Maintains working knowledge of multiple payer websites
Maintains knowledge of all government and non-governmental industry regulation changes.
High school diploma or GED required.
One-year experience in accounts receivable or health insurance in a medical setting required
A minimum of one-year current experience of CPT, ICD-10, and HCFA 1500.
Certified Professional Coder (CPC).
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Requisition ID 2020-128087
Employment Type Full Time
Department Physicians Billing System
Hours / Pay Period 80
Standard Hours Monday - Friday (8:00 AM - 5:00 PM)
Facility / Process Level : Name Mercy Medical Physician Practi
Location IA-DES MOINES
Equal Opportunity CommonSpirit Health™ is an Equal Opportunity/ Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law.
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