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CommonSpirit Health Patient Account Rep II - Physician Billing Office in DES MOINES, Iowa

Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community.

Responsibilities

GENERAL SUMMARY:

Adhere to corporate policies and procedures as dictated by the specific job. 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.

ESSENTIAL FUNCTIONS:

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

MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED :

  • High school diploma or GED required.

  • One year experience in accounts receivable, banking, or office setting required.

  • 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.

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Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law.

External hires must pass a post offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances .

If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request . We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA).

CommonSpirit Health participates in E-verify.

Requisition ID 2020-110091

Employment Type Full Time

Department Physicians Billing System

Hours Per Pay Period 80

Facility MercyOne Des Moines Medical Center

Shift Day

Standard Hours Days

Work Schedule 8 Hour

Location IA-DES MOINES

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