Financial Resource Specialist

1 day ago

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

Mercy Health is seeking a highly skilled Financial Resource Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely billing and collections processes.

Key Responsibilities
  • Administer all Mercy Health financial policies and guidelines.
  • Counsel patients and customers 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 other patient billing/insurance issues.
  • Navigate the billing system and review patient accounts for accuracy.
  • Initiate follow-up with patients, billing department, coding department, and insurance companies to ensure payment for services.
  • Maintain a knowledge base of programs offered through the government, the insurance marketplace, and the Mercy Community Care program.
  • Screen self-pay patients for presumptive eligibility for Medicaid and perform necessary follow-up to ensure coverage is in place.
  • Establish payment plans with patients and follow up on broken payment arrangements.
  • Educate patients and other Mercy partners on payment guidelines and resources.
  • Monitor patient work queues and resolve outstanding balance issues.
  • Contact 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.
  • Perform insurance verification and pre-certification activities for procedures when necessary.
  • Record and maintain thorough documentation of activities performed and patient conversations on the patient's account.
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.

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