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Patient Account Rep II

Company: MercyOne
Location: Des Moines
Posted on: January 16, 2022

Job Description:

Overview:
CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities:
Demonstrates written, verbal, and nonverbal communication that is consistent with the Mercy Mission, Values and I Will Statements to all patients, families, visitors, medical staff, colleagues, vendors and other internal and external customers.Promotes the Spirit of Mercy by displaying an attitude and behaviors that are consistent with the Mercy Mission, Value and I Will Statements.Acknowledges patient rights with regard to confidentiality by maintaining patient confidentiality and following HIPAA guidelines and regulations at all times.Acts as a patient advocate by responding to and addressing all patient concerns in a timely manner.Maintains current on all mandatory employment requirements including but not limited to Orientation Attendance (new hires), CHI Mandatory Education Courses, CHI additional Education Courses, Health Review, TB Testing and Annual Flu Shot.Must be a self- started and demonstrate the ability to work independently by making appropriate decisions according to the organizational and departmental guidelines that fall within the scope of the position.Demonstrates the ability to understand and effectively utilize a highly complex billing system(s). Maintains current knowledge of all Federal, State and compliance regulations related to billing and insurance as required based on the scope of the position.Demonstrates an understanding of HCFA 1500 claim forms, CPT, ICD.9 and HCPCS codes specific to insurance carrier requirements as required based on scope of the position.Maintains clear and concise documentation in claims and/or online notes as required based on the scope of the position.Participates effectively as a team member. Maintains competent job performance or better.Maintains an organized work area that enhances the organizational/departmental image. Reports all issues related to workflow backlog or identified process related concerns to Manager.Patient Account Rep II - Follow-up 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 managerMaintains claim and online notes

Qualifications:
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 required.High school diploma or GED required.

Keywords: MercyOne, Des Moines , Patient Account Rep II, Other , Des Moines, Iowa

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