Patient Account Rep Job at MercyOne Central Iowa Clinics
MercyOne Central Iowa Clinics Des Moines, IA 50309
$15.30 - $19.67 an hour
Overview
MercyOne Central Iowa operates four not-for-profit Catholic medical centers in Des Moines West Des Moines Newton and Centerville and two specialty hospitals – MercyOne Children’s Hospital in Des Moines and MercyOne Rehabilitation Hospital in Clive (965 beds total) – along with more than 20 additional facilities that house more than 50 primary care pediatric internal medicine and specialty clinics. Founded by the Sisters of Mercy in 1893 MercyOne Central Iowa has the longest continually operating hospital in Des Moines and is also one of the largest employers in the state with more than 7000 employees and a medical staff of more than 1000 physicians and allied health associates. MercyOne Central Iowa is a member of MercyOne which was founded in 1998 through a collaboration between CommonSpirit Health and Trinity Health – two of the country’s foremost not-for-profit Catholic health organizations. MercyOne has more than 20,000 colleagues in Iowa and surrounding states.
We offer the following benefits to support you and your family:
Responsibilities
The Patient Account Rep II will have the ability to interpret explanation of benefits and correspondence from multiple payers. Contact payers, patients, or clinics to resolve claim issues. Work accounts as dictated by the specific job. Is knowledgeable with insurance carriers’ policies and procedures. Adhere to all productivity expectations and quality assurance standards. Provide excellent customer service consistent with Mercy’s philosophy and guidelines.
Follow-up
Qualifications
Pay Range
$15.30 - $19.67 /hour
MercyOne Central Iowa operates four not-for-profit Catholic medical centers in Des Moines West Des Moines Newton and Centerville and two specialty hospitals – MercyOne Children’s Hospital in Des Moines and MercyOne Rehabilitation Hospital in Clive (965 beds total) – along with more than 20 additional facilities that house more than 50 primary care pediatric internal medicine and specialty clinics. Founded by the Sisters of Mercy in 1893 MercyOne Central Iowa has the longest continually operating hospital in Des Moines and is also one of the largest employers in the state with more than 7000 employees and a medical staff of more than 1000 physicians and allied health associates. MercyOne Central Iowa is a member of MercyOne which was founded in 1998 through a collaboration between CommonSpirit Health and Trinity Health – two of the country’s foremost not-for-profit Catholic health organizations. MercyOne has more than 20,000 colleagues in Iowa and surrounding states.
We offer the following benefits to support you and your family:
- Health/Dental/Vision Insurance
- Flexible spending accounts
- Voluntary Protection: Group Accident, Critical Illness, and Identity Theft
- Free Premium Membership to Care.com with preloaded credits for children and/or dependent adults
- Employee Assistance Program (EAP) for you and your family
- Paid Time Off (PTO)
- Tuition Assistance for career growth and development
- Matching 401(k) and 457(b) Retirement Programs
- Wellness Program
Sign-on bonus of $500 available for qualifying applicants!
Responsibilities
The Patient Account Rep II will have the ability to interpret explanation of benefits and correspondence from multiple payers. Contact payers, patients, or clinics to resolve claim issues. Work accounts as dictated by the specific job. Is knowledgeable with insurance carriers’ policies and procedures. Adhere to all productivity expectations and quality assurance standards. Provide excellent customer service consistent with Mercy’s philosophy and guidelines.
What You'll Do:
Follow-up
- Responsible for reviewing, correcting and filing unpaid or previously adjudicated claims as assigned
- Contacts insurance carriers, patients, and clinics to resolve claim issues.
- Participates in recognizing denial trends and provides feedback to manager
Credit Balance (Insurance):
- Research and resolve all insurance/business overpayments
- Maintain knowledge of payment posting and follow-up processes
- Review and respond to carrier correspondence requesting refunds
Credit Balance (Patient):
- Research and resolve all patient credit balances
- Communicate with guarantors and patients regarding questions related to patient refunds.
- Works unassigned payment queues and reports.
Cash/Zero Pay Posting
- Responsible for the posting of all assigned cash payments, adjustments and remark codes,
- Reconciles and balances all batches.
- Contacts payers to resolve issues necessary in order to reconcile, apply payments, and bring variances to resolution.
Customer Service:
- Manages large amount of incoming calls and assists walk in customers
- Handles customer complaints, provides appropriate solutions within time limits, and follows up to ensure resolution.
- Follows communication procedures, guidelines and policies.
Collections:
- Reviews and moves accounts through the pre-collection process before placing with collection agency
- Handles inbound and outbound collection calls.
- Is responsible for all bad address and legal correspondence, probates, and bankruptcy
Financial Assistance:
- Reviews all applications to determine if the account qualifies for charity
- Is knowledgeable and adheres to the CHI Financial Assistance policy
Qualifications
- High school diploma or GED required.
- One year experience in accounts receivable, banking, or office setting required.
- Proof of completion of Mandatory Reporter abuse training specific to population served within three (3) months of hire.
- A minimum of one year current experience of CPT, ICD-10, and HCFA 1500 preferred.
- Successful completion of a medical terminology class preferred.
- One year 10 key experience preferred.
- 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.
- 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 preferred.
- Demonstrates an understanding of HCFA 1500 claim forms, CPT, ICD.9 and HCPCS codes specific to insurance carrier requirements preferred.
Pay Range
$15.30 - $19.67 /hour
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