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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:

Responsible for the research, posting, and reconciling of payments, contractual adjustments, and denials. Ability to interpret different explanation of benefits and remittance advices from multiple payer. Contacting payers to resolve any discrepancies. Adhere to all cash posting processes, productivity expectations, and quality assurance standards.

ESSENTIAL FUNCTIONS:

• 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.

• Promotes the Spirit of Mercy by displaying an attitude and behaviors that are consistent with the Mercy Mission, Value and I Will Statements.

• Acknowledges patient rights with regard to confidentiality by maintaining patient confidentiality and following HIPAA guidelines and regulations at all times.

• Acts as a patient advocate by responding to and addressing all patient concerns in a timely manner.

• Maintains current on all mandatory employment requirements including but not limited to Orientation Attendance (new hires), CHI Mandatory Education Courses, CHI additional Education Courses, Health Review, TB Testing and Annual Flu Shot.

• 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 as required based on the scope of the position.

• Demonstrates an understanding of HCFA 1500 claim forms, CPT, ICD.9 and HCPCS codes specific to insurance carrier requirements as required based on scope of the position.

• Maintains clear and concise documentation in claims and/or online notes as required based on the scope of the position.

• Participates effectively as a team member.

• Maintains competent job performance or better.

• Maintains an organized work area that enhances the organizational/departmental image.

• Reports any and all issues related to workflow backlog or identified process related concerns to Manager.

Patient Account Rep II – Cash Posting

• Responsible for the posting of all assigned cash payments, adjustments, and/or remark codes to the appropriate claim, service date and/or account from all EOB’s and ERA’s.

• Possesses ability to comprehend complex insurance claims and explanations of benefits in various payer formats

• Adheres to all cash posting processes and protocols

• Contacts payers to resolve issues necessary in order to reconcile and apply payments

• Reconciles each batch to the check deposit amount

• Initiates the refund/recoup process for all credit balances

• Maintains ability to recognize claim denials on EOB’s/ERA’s and applies information appropriately to allow for additional follow up as necessary

• Brings all variances to resolution within established timeframes

• Maintains productivity standards defined by management.

• Ability to research errors that resulted in unposted claim payments.

• Coordinate activities for unidentified payments.

• Maintains working knowledge of multiple payer websites

• Maintains knowledge of all government and non-governmental industry regulation changes.

Qualifications

Minimum Qualifications

Required Education for Staff Job Levels

High school diploma or GED required.

Required Licensure and Certifications

N/A

Required Minimum Knowledge, Skills and Abilities

One year experience in accounts receivable required, preferably in a healthcare related industry.

PREFERRED Qualifications

  • One year 10 key experience preferred.

  • One year experience in CPT, ICD-10, HICFA 1500 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 2020-110440

Employment Type Full Time

Department Physicians Billing System

Hours Per Pay Period 80

Facility MercyOne Des Moines Medical Center

Shift Day

Standard Hours Day

Work Schedule 8 Hour

Location IA-DES MOINES

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