
Financial Resource Specialist
WALWORTH, WIJobSeen todaySeen in employer's feed today
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Job overview
The Financial Resource Specialist administers Mercyhealth financial policies and supports patient account resolution. The role researches balances, explains billing and insurance concerns, establishes payment arrangements, and helps patients access financial assistance. It also verifies insurance eligibility and benefits, completes precertifications, monitors work queues, and coordinates with patients, clinical staff, billing and coding departments, and insurers to support payment for services.
Skills & qualifications
Skills
Full job description
JOB REQUIREMENTS: Essential Duties and Responsibilities Follow and administer all Mercyhealth financial policies and guidelines. In depth knowledge of collection laws, an understanding of statement cycles, and the bad debt process. Maintain a thorough knowledge base of the registration and cash drawer process. Follow all necessary frontline workflows in regards to payment posting, cash drawer balancing and adhere to all cash compliance policies. Researches and performs audits on patient accounts to determine where balances are due, from third party payers or patient responsibility. Meet with patients in person or via telephone to counsel patients/customers on billing concerns, account balances, services costs/estimates and various insurance resources. Establish payment plans with patients and follow up on broken payment arrangements when appropriate. Research patient accounts, process refunds and pay in full discounts. Communicate with physicians, patient care staff and hospital/clinic reception regarding out of network insurance status, medical urgency and other patient billing/ insurance issues. Thorough understanding of how to identify if charges are correct. In depth understanding of what information is available to assist in the process, such as the medical record, chartview, MPI, billing, and coding reviews as appropriate Navigate the billing system and review patient accounts for accuracy. Initiates appropriate follow-up with patient, billing department, coding department, and insurance companies to ensure payment for services. Familiar with managed care contract reimbursement rates. Understands terminology associated with contracts as well as familiar with terminology and calculations used on a payment voucher and patient's explanation of benefits. Understands Governmental and Commercial insurance reimbursement rates. Maintain an extensive knowledge base of programs offered through the government, the insurance marketplace, Care Credit, foundation grants, and other financial resource options. Assist patients in obtaining copay and drug replacement assistance for services provided. Screens patients in need and provides assistance with completion of the charity care application process. Screens self-pay patients for presumptive eligibility for Medicaid and performs necessary follow-up to ensure coverage is in place. Initiates appropriate follow-up with patients, insurance companies or billing department to ensure payment for services. Completes insurance eligibility, benefit verification and precertifications as required. Monitor patient work queues and resolve outstanding balance issues. Contacts patients with self-pay balances to collect payment, set payment arrangements, or provide assistance with financial resources. Responds to patient inquiries via in person, mail, phone,... For full info follow application link. EOE&AA/M/F/Vet/Disabled. Mercy is an equal employment opportunity employer functioning under Affirmative Action Plans. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/7F896312294C4B15
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