Home Health Hospice Patient Accounts

JOB REQUIREMENTS: OVERVIEW: Experienced healthcare revenue cycle professional with expertise in claims processing, billing, coding, payer regulations, and reimbursement. Skilled in Epic/Brightree, denial resolution, EOBs, payer portals, and collections, with a strong ability to independently resolve complex billing issues and maintain accurate, timely accounts. SCHEDULE: Full Time, 40 hours/week ESSENTIAL DUTIES AND RESPONSIBILITIES Processes claims on a daily basis by demonstrating in-depth knowledge of billing procedures by payer and ensures claims being worked remain timely per department standards. Understands Epic/Brightree billing edits used to stop a claim from being transmitted electronically and understands how to research information as needed to correct the claim Maintains in-depth knowledge of all Federal and State regulations to ensure all claims billed to Medicare and Medicaid are correct and that issues resulting in inaccurate claims are brought to the attention of the supervisor. Is knowledgeable of CPT/HCPC coding and use of modifiers in payment determinations. Understands various managed care reimbursement methodologies related to department payment Collects and enters information relating to patient accounts in a timely manner and ensures Epic/Brightree system is updated to accurately reflect the current status of patient accounts. Understands computer system processing to identify possible processing errors and establishes contacts at the payors to resolve contract issues. Ensures all insurance related mail/correspondence is worked and remains current Prioritizes work effectively to prevent backlogs and ensures follow-up is done on all accounts/claims on their worklist on a daily/weekly basis, ensuring that all claims/accounts have no follow-up dates that fall into previous months and notifies supervisor of any backlogs. Works independently to identify and resolve claim denials and rejections. Understands and navigates payer portals, websites and manuals. Interprets and post EOBs. Investigates and resolves patient inquiries. Performs all functions related to the collection of delinquent accounts, including follow up phone calls, resubmission of claims to third party payers, collections letters, and processing accounts for collection agencies. CULTURE OF EXCELLENCE BEHAVIOR EXPECTATIONS To perform the job successfully, an individual should demonstrate the following behavior expectations: Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals. Service - Responds promptly to requests for... 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/5EDEFCC4E44E4464