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Financial Resource Specialist

2 months ago

Lake Geneva Wisconsin, United States Mercyhealth Full time
Job Summary

Mercyhealth is seeking a 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 financial reimbursement for patient care services.

Key Responsibilities
  • Verify and authorize patient care services to ensure financial reimbursement
  • Contact insurance companies and employer groups to determine eligibility and benefits for necessary services
  • Communicate effectively with clinical offices and primary care physicians to resolve issues related to incomplete or invalid referrals
  • Follow up with insurance companies to ensure financial resolution and payment on accounts
  • Obtain required clinical documentation for authorization purposes
  • Ensure timely documentation and communication of referral authorization/precertification in appropriate systems
  • Resolve pre-certification, registration, and case-related concerns prior to a patient's appointment
  • Coordinate follow-up to ensure all payor requirements are met and payment is expected
  • Maintain current knowledge of payor payment provisions and regulations
  • Assist with appeals and denials related to referrals
Requirements
  • High school diploma or equivalent required
  • One year of healthcare registration, scheduling, or physicians' office experience required
  • Basic knowledge of medical terminology, ICD-9, ICD-10, and CPT coding preferred
  • Excellent customer service and telephone etiquette
  • Proficient with Microsoft Office Suite, including Outlook, Excel, and Word
  • Ability to communicate clearly and concisely, both verbally and in writing
Working Conditions

The Financial Resource Specialist will work in a fast-paced environment and will be required to sit for long periods of time while working at a computer. The employee will also be required to walk, use hands to finger, handle, or feel, reach with hands and arms, climb or balance, stoop, kneel, crouch, or crawl, and talk or hear.

Language

The primary language used for this role is English.