Thank you for considering a career at Bon Secours Mercy Health!
Scheduled Weekly Hours:
40
Work Shift:
Days (United States of America)
The Accounts Receivable Specialist is responsible for implementation and coordination of fiscal transactions in a timely and accurate manner. This includes claims processing, cash collection, claims resolution, resolving credit balances, EOM balancing and monthly statements. Responsible for pre claim review to assure billing compliance as required by company. Is accountable for complying with all policies, procedures and regulations related to billing all Medicare, Medicaid and other Third Party Payors.
ESSENTIAL FUNCTIONS
Examines denied and underpaid claims to determine reason for discrepancies. Communicates directly with payers to follow up on outstanding claims, file appeals, resolve payment variances, and ensure timely reimbursement. Ability to identify with specific reason underpayments, denials, and cause of payment delay. Works with management to identify, trend, and address root causes of issues in the A/R. Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and taken appropriate action accordingly. Documents activity accurately including contact names, addresses, phone numbers, and other pertinent information. Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management. Needs to be a strong problem solver and critical thinker to resolve accounts.
Responsibilities include posting remittance advice to patient accounts, resolving any errors after posting payments, posting guarantor payments, reconciling all posted cash, and requesting refunds.
Submit claims electronically or by paper according to payor specifications and filing limits.
Performs pre billing audits to assure billing compliance as required by company.
Answers all incoming phone calls to the business line accepting payments, answering billing questions, assisting patients with financial assistance and providing service recovery as needed.
Process patients statements monthly per policy.
Reviews all credit balances and processes as required by Medicare, Medicaid and all Third Party Payors.
MINIMUM EDUCATION
HS Diploma or GED
Associates Degree Preferred
MINIMUM QUALIFICATIONS :
Minimum Years and Type of Experience: 2 years of experience in a health care front or back office setting required. 2 years insurance verification with multiple Government and Commercial payers using provider portals required.
Other Knowledge, Skills and Abilities Required: Basic keyboarding and computer skills, ability to use standard office equipment (phone, fax, copier, printer). Excellent customer service skills including ability to work well with co-workers.
Other Knowledge, Skills and Abilities Preferred: Experience in multiple areas of pre-service(pre registration, financial clearance, obtaining pre-cert/authorization) preferred. Knowledge and training in medical terminology preferred.
Bon Secours Mercy Health is an equal opportunity employer.
Many of our opportunities reward* your hard work with:
- Comprehensive, affordable medical, dental and vision plans
- Prescription drug coverage
- Flexible spending accounts
- Life insurance w/AD&D
- Employer contributions to retirement savings plan when eligible
- Paid time off
- Educational Assistance
- And much more
*Benefits offerings vary according to employment status.
Department:
Billing Operations - Life Flight Network
It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a). Accordingly, all applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health– Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email [email protected]. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at [email protected].
What We Do
At Mercy Health, we understand that every family is a universe. A network of people who love, and support, and count on one other to be there. Everybody means the world to someone and we are committed to care for others so they can be there for the ones they love. With nearly 35,000 employees across regions of Ohio and Kentucky, we’re one of the largest health care systems in the country. At each of our more than 600 points of care, we deliver high-quality, compassionate care with one united purpose: to help our patients be well in mind, body and spirit.