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

Overview

MercyOne Central Iowa operates four not-for-profit, Catholic medical centers in Des Moines, West Des Moines, Newton and Centerville and two specialty hospitals – MercyOne Children’s Hospital in Des Moines and MercyOne Rehabilitation Hospital in Clive (965 beds total) – along with more than 20 additional facilities that house more than 50 primary care, pediatric, internal medicine and specialty clinics. Founded by the Sisters of Mercy in 1893, MercyOne Central Iowa has the longest continually operating hospital in Des Moines and is also one of the largest employers in the state, with more than 7,000 employees and a medical staff of more than 1,000 physicians and allied health associates. MercyOne Central Iowa is a member of MercyOne, which was founded in 1998 through a collaboration between CommonSpirit Health and Trinity Health – two of the country’s foremost, not-for-profit Catholic health organizations. MercyOne has more than 20,000 colleagues in Iowa and surrounding states.

Responsibilities

Job Summary / Purpose

Reviews and researches all unpaid claims. Contacts insurance carriers, patients, and clinics to resolve claim issues. Corrects accounts as necessary and resubmits claims according to the insurance company guidelines.

Essential Key Job Responsibilities

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

Patient Account Rep II - Follow-up

  • Responsible for reviewing accounts for correct third-party billing as assigned.

  • Contacts insurance carriers, patients, and clinics to resolve claim issues.

  • Updates patient registration and insurance as needed to correctly file claims.

  • Ability to process complex claim correction involving both pending and previously adjudicated claims.

  • Ability to utilize high level thinking and problem solving to bring complex claims to resolution.

  • Files claims according to insurance company guidelines.

  • Participates in recognizing denial trends and provides feedback to manager

  • Maintains claim and online notes

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 2020-116516

Employment Type Full Time

Department Physicians Billing System

Hours Per Pay Period 80

Facility MercyOne Des Moines Medical Center

Shift Day

Standard Hours Monday - Friday (8:00 AM - 5:00 PM)

Work Schedule 8 Hour

Location IA-DES MOINES

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