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Financial Resource Specialist

2 months ago

Harvard, Illinois, United States Mercy Health Full time
Job Summary

The Financial Resource Specialist position at Mercy Health requires a strong understanding of financial guidelines, collection policies, and regulations related to billing and collections. This role is responsible for ensuring that financial policies are being adhered to across various clinic and hospital locations. The ideal candidate will have excellent communication skills, problem-solving abilities, and knowledge of healthcare systems and databases.

Key Responsibilities
  • Meet with patients face-to-face or via telephone to counsel on billing concerns, account balances, and services costs/estimates.
  • Communicate with physicians, patient care staff, and hospital/clinic reception regarding out-of-network insurance status and patient billing/insurance issues.
  • Navigate the billing system and review patient accounts for accuracy, initiating follow-up with patients, billing department, coding department, and insurance companies as needed.
  • Maintain a knowledge base of programs offered through the government, insurance marketplace, and Mercy Community Care program, screening self-pay patients for presumptive eligibility for Medicaid and performing necessary follow-up.
  • Establish payment plans with patients and follow up on broken payment arrangements, educating patients and Mercy partners on payment guidelines and resources.
  • Monitor patient work queues and resolve outstanding balance issues, contacting patients with self-pay balances to collect payment and/or set payment arrangements.
  • Responsible for meeting Patient Access department guidelines for daily patient contact, collection goals, and department benchmarks.
  • Research denied claims through review of system/account/process to reconcile information, performing insurance verification and pre-certification activities for procedures when necessary.
  • Record and maintain thorough documentation of activities performed and patient conversations on patient records.
Requirements
  • Graduate of high school or equivalent.
  • One year customer service and/or collections experience required.
  • Knowledge of reimbursement practices for commercial and government payers preferred.
  • Medical terminology preferred.
Competencies
  • Excellent oral and written communication skills/organizational skills.
  • Strong problem-solving skills.
  • Knowledge of various health care systems and databases desirable.
  • Knowledge of general computer applications (word, excel, outlook, etc.).
Language Skills
  • Ability to read and interpret documents such as emails, insurance documents, guidelines, instructions, and procedure manuals.
  • Ability to write routine reports and correspondence.
  • Ability to speak and communicate effectively to customers and other partners.
  • Ability to speak Spanish desirable.
Mathematical Skills
  • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
  • Ability to compute rate, ratio, and percent and to draw and interpret basic graphs.
Reasoning Ability
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
  • Ability to deal with problems involving several concrete variables in standardized situations.