Biller, Patient Financial Services

OVERVIEW

Responsible for processing and submitting accurate medical claims while ensuring compliance with insurance regulations and billing requirements. Reviews and resolves claim errors, verifies coding and documentation, and works with internal departments and insurance providers to address billing issues and prevent delays. Maintains current knowledge of payer guidelines and works to meet productivity goals while supporting efficient revenue cycle operations.

SCHDULE: 40-hours per week

ESSENTIAL DUTIES AND 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.

EDUCATION AND/OR EXPERIENCE

• High school diploma or equivalent.
• Microsoft Excel required and healthcare billing experience preferred.
• Undertakes self-development activities.

CERTIFICATION/LICENSURE

N/A

OTHER SKILLS AND ABILITIES

Should understand how to work with others to impact change.

LEVEL OF SUPERVISION

N/A

SUPERVISES

This job has no supervisory responsibilities; however, should understand how to work with others to impact change.

PAY RANGE:

Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.

Mercyhealth offers competitive pay and a comprehensive benefits package including:

• Medical, Dental, Vision

• Life & Disability Insurance

• FSA/HSA Options

• Generous, accruing paid time off

• Paid Parental and caregiver leave

• Career advancement and educational opportunities

• Tuition and certification reimbursement

• Certification Reimbursement

• Well-being Programs

• Employee Discounts

• On-Demand Pay

• Financial Education

• Annual recognition/awards events

• Partner appreciation days

• Family entertainment/attractions discount

• Community service/improvement opportunities

Click here for more details regarding Mercyhealth Careers Benefit Information.

At Mercyhealth, we don’t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.

Mercyhealth has been nationally recognized for our commitment to our people and culture, including:

• #1 in the nation on AARP's Best Employers for Workers Over 50

• One of Working Mother magazine's 100 Best Companies for Working Mothers

• A Top 50 Company and Top 10 Nonprofit for Executive Women