Address
Form of work
SalaryOverview:
- Biller, Patient Accounts, Days, 80 Hrs / 2 wks
- Rockford, IL OR Janesville, WI, OR Remote for those with experience.
- Hybrid remote optional as well and flexible work schedule available. Mercyhealth does not currently support remote workers with residency in the following states: CA, OH, OR, PA, NJ, NY.
Responsible for ensuring medical claims are sent to third party payers in a reasonable time frame as defined by Revenue Cycle metrics. This includes working claims that fail billing edits in order to resolve errors and submit corrected claims. Assesses errors and quickly and effectively locates information to correct them and release claims for transmission. Works with internal and external areas to obtain information necessary to correct errors or supply additional information. Remains up-to-date on regulatory requirements through informal and formal updates, including payer bulletins and guidelines. Performs other duties as assigned.
Responsibilities: - Submits medical claims both electronically and manually, and uses all technology available to produce clean claims for their assigned workgroup.
- Interprets claims processing reports and applies information to produce clean claims.
- Maintains current knowledge of regulatory billing requirements.
- Makes changes to demographic information as necessary in order to produce a clean claim.
- Must have the ability to analyze coding to assure proper billing of claim.
- Participates in a variety of hospital and physician educational programs to maintain current skill and competency levels.
- Requests and attaches required clinical documentation in accordance with third party requirements.
- Reviews failed claims; resolve claims stopped for claim edits, or billing errors.
- Access available resources, such as the patient accounting system, biller files, or payer databases, to locate missing or incorrect information. Apply creative problem solving skills in order to overcome obstacles and resolve errors.
- Coordinate with management and external departments to resolve unbilled accounts and potentially recommend process redesign initiatives for long term root cause resolution. Completes special projects as assigned.
- Maintains a comprehensive awareness of insurance company updates including Federal and State guidelines.
- Meets productivity goals as assigned by the Revenue Cycle Director.
High school diploma or equivalent. Microsoft Excel required and healthcare billing experience preferred. Undertakes self-development activities.
Special Physicial Demands: The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is most often required to sit; use hands to finger, handle, or feel and reach with hands and arms. The employee is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, depth perception and ability to adjust focus.
Culture of Excellence Behavior Expectations:While performing the duties of this job, the employee is regularly required to talk or hear. The employee is most often required to sit; use hands to finger, handle, or feel and reach with hands and arms. The employee is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, depth perception and ability to adjust focus.
