At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.The Accounts Receivable Specialist is responsible for implementation and coordination of fiscal transactions in a timely and accurate manner. This includes claims processing, cash collection, claims resolution, resolving credit balances, EOM balancing and monthly statements. Responsible for pre claim review to assure billing compliance as required by company. Is accountable for complying with all policies, procedures and regulations related to billing all Medicare, Medicaid and other Third Party Payors.ESSENTIAL FUNCTIONSExamines denied and underpaid claims to determine reason for discrepancies. Communicates directly with payers to follow up on outstanding claims, file appeals, resolve payment variances, and ensure timely reimbursement. Ability to identify with specific reason underpayments, denials, and cause of payment delay. Works with management to identify, trend, and address root causes of issues in the A/R. Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and taken appropriate action accordingly. Documents activity accurately including contact names, addresses, phone numbers, and other pertinent information. Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management. Needs to be a strong problem solver and critical thinker to resolve accounts.Responsibilities include posting remittance advice to patient accounts, resolving any errors after posting payments, posting guarantor payments, reconciling all posted cash, and requesting refunds.Submit claims electronically or by paper according to payor specifications and filing limits.Performs pre billing audits to assure billing compliance as required by company.Answers all incoming phone calls to the business line accepting payments, answering billing questions, assisting patients with financial assistance and providing service recovery as needed.Process patients statements monthly per policy.Reviews all credit balances and processes as required by Medicare, Medicaid and all Third Party Payors.MINIMUM EDUCATIONHS Diploma or GEDAssociates Degree PreferredMINIMUM QUALIFICATIONS :Minimum Years and Type of Experience: 2 years of experience in a health care front or back office setting required. 2 years insurance verification with multiple Government and Commercial payers using provider portals required.Other Knowledge, Skills and Abilities Required: Basic keyboarding and computer skills, ability to use standard office equipment (phone, fax, copier, printer). Excellent customer service skills including ability to work well with co-workers.Other Knowledge, Skills and Abilities Preferred: Experience in multiple areas of pre-service(pre registration, financial clearance, obtaining pre-cert/authorization) preferred. Knowledge and training in medical terminology preferred.Many of our opportunities reward your hard work with:Comprehensive, affordable medical, dental and vision plansPrescription drug coverageFlexible spending accountsLife insurance w/AD&DEmployer contributions to retirement savings plan when eligiblePaid time offEducational AssistanceAnd much moreBenefits offerings vary according to employment statusAll applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com
