Catholic Health Initiatives Patient Account Rep II - Physician Billing Office in DES MOINES, Iowa
Patient Account Rep II - Physician Billing Office
Location: DES MOINES, IOWA, UNITED STATES
Requisition #: 2020-R0279177
Post Date: Mar 26, 2020
Position Type: Regular
Scheduled Hours per 2 week Pay Period: 80
Primary Location: IA > DES MOINES > MERCY MEDICAL CENTER
JOB SUMMARY / PURPOSE:
Reviews and researches all unpaid claims. Contacts insurance carriers, patients, and clinics to resolve claim issues. Corrects accounts as necessary and resubmits claims according to the insurance company guidelines.
ESSENTIAL KEY JOB 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 manager
• Maintains claim and online notes
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 required.
Requisition ID: 2020-R0279177
Market: Mercy Medical Center
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Equal Opportunity Employment
Consistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applications will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disability or any other legally protected characteristic