What are the responsibilities and job description for the Patient Financial Services -Biller 1 position at Mercyhealth?
Overview:
Culture of Excellence Behavior Expectations
Education and Experience
Certification and Licensure
Skills and Abilities
Should understand how to work with others to impact change.
Special Physical Demands
Level of Supervision
Supervises
- Biller, Patient Accounts, Days, 80 Hrs/2 wks
- Location: Rockton Ave, Rockford, IL or MercyCare Bldg, Janesville, WI
- Hybrid and flexible work schedule opportunities available after probationary period.
Responsible for ensuring medical claims are sent to third party payers in a reasonable time frame as defined by Revenue Cycle metrics. This includes working claims that fail billing edits in order to resolve errors and submit corrected claims. Assesses errors and quickly and effectively locates information to correct them and release claims for transmission. Works with internal and external areas to obtain information necessary to correct errors or supply additional information. Remains up-to-date on regulatory requirements through informal and formal updates, including payer bulletins and guidelines. Performs other duties as assigned.
Responsibilities:
Essential Duties and Responsibilities
- Submits medical claims both electronically and manually, and uses all technology available to produce clean claims for their assigned workgroup.
- Interprets claims processing reports and applies information to produce clean claims.
- Maintains current knowledge of regulatory billing requirements.
- Makes changes to demographic information as necessary in order to produce a clean claim.
- Must have the ability to analyze coding to assure proper billing of claim.
- Participates in a variety of hospital and physician educational programs to maintain current skill and competency levels.
- Requests and attaches required clinical documentation in accordance with third party requirements.
- Reviews failed claims; resolve claims stopped for claim edits, or billing errors.
- Access available resources, such as the patient accounting system, biller files, or payer databases, to locate missing or incorrect information. Apply creative problem solving skills in order to overcome obstacles and resolve errors.
- Coordinate with management and external departments to resolve unbilled accounts and potentially recommend process redesign initiatives for long term root cause resolution. Completes special projects as assigned.
- Maintains a comprehensive awareness of insurance company updates including Federal and State guidelines.
- Meets productivity goals as assigned by the Revenue Cycle Director.
Culture of Excellence Behavior Expectations
To perform the job successfully, an individual should demonstrate the following behavior expectations:
Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.
Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.
Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.
Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.
Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.
Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.
Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.
Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.
Education and Experience
High school diploma or equivalent. Microsoft Excel required and healthcare billing experience preferred. Undertakes self-development activities.
Certification and Licensure
N/A
Skills and Abilities
Should understand how to work with others to impact change.
Special Physical Demands
The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is most often required to sit; use hands to finger, handle, or feel and reach with hands and arms. The employee is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, depth perception and ability to adjust focus.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is most often required to sit; use hands to finger, handle, or feel and reach with hands and arms. The employee is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, depth perception and ability to adjust focus.
Level of Supervision
N/A
Supervises
This job has no supervisory responsibilities; however should understand how to work with others to impact change.
Benefits:
Mercyhealth offers a generous total rewards package to eligible employees including, but not limited to:
- Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.
- Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.
- Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance.
- Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.
- Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.
- Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning.
