Patient Financial Services Follow Up

This is a fully remote position, open to applicants in United States.

📋 Description

• Confirm that claims are received by payers and follow up via phone, portals, or websites to secure payment.

• Analyze claim adjustment reason codes and explanations of benefits to pinpoint denial reasons and decide on follow-up actions.

• Engage with payers, resubmit claims, and address disputes, appeals, and reconsiderations as necessary.

• Prepare appeals and complete reconsideration forms in accordance with payer requirements.

• Acquire and submit medical records to support medical necessity during the appeals process.

• Examine both paper and electronic billing forms for precision.

• Reach out to patients or payers to gather information required to resolve account balances.

• Identify trends in payer rejections and denials, escalating these issues to leads or supervisors.

• Utilize computer systems and payer databases to find claim information and resolve account balances.

• Adhere to patient financial services policies and procedures.

• Review accounts based on inquiries from patients or departments.

• Follow up with Mercyhealth departments regarding unresolved inquiries and at-risk claims.

• Share knowledge and provide training to Patient Financial Services staff.

• Investigate high-level No Authorization denials and appeal or escalate these to Precertification.

• Execute billing functions as necessary.

• Escalate high-value accounts for second-level appeals.

• Report any equipment malfunctions and supply requirements.

• Research patient accounting, revenue cycle, biller, and payer resources for any missing or incorrect information.

• Utilize creative problem-solving to correct claim adjudication errors.

• Collaborate with management and external departments regarding unresolved accounts and process redesign initiatives.

• Complete special projects as assigned.

• Stay informed about updates from insurance companies and Federal and State guidelines.

• Achieve productivity goals set by the Revenue Cycle Director.

⛳️ Requirements

• High school diploma or equivalent is required.

• Proficiency in Microsoft Excel is required.

• Experience in healthcare billing is preferred.

• Basic understanding of operating multiple software applications simultaneously.

• Basic business writing skills are necessary.

• Ability to collaborate with others to drive change.

• Capability to use computer systems and technology to find claims information.

• Knowledge of updates from insurance companies, including Federal and State guidelines.

🏝️ Benefits

• Medical, Dental, Vision.

• Life & Disability Insurance.

• FSA/HSA Options.

• Generous, accruing paid time off.

• Paid Parental and caregiver leave.

• Opportunities for career advancement and education.

• Tuition and certification reimbursement.

• Certification Reimbursement.

• Well-being Programs.

• Employee Discounts.

• On-Demand Pay.

• Financial Education.

• Annual recognition/awards events.

• Partner appreciation days.

• Family entertainment/attractions discount.

• Opportunities for community service/improvement.