Mercyhealth Wisconsin and Illinois
Financial Resource Specialist
Mercyhealth Wisconsin and Illinois, Janesville, Wisconsin, United States, 53546
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Financial Resource Specialist
role at
Mercyhealth Wisconsin and Illinois
Overview The Financial Resource Specialist position requires extensive knowledge of Mercyhealth financial guidelines, collection policies, and government regulations related to billing and collections. The specialist will embody the hospital's mission, vision and values and liaison with clinic and hospital locations to ensure financial policies are adhered to. The specialist will greet patients or family members in clinic and hospital settings and assist with questions regarding insurance coverage, financial assistance, billing or payment options. The specialist will have knowledge of revenue department from registration through collection, billing, coding and denial processes and a comprehensive knowledge base of community, state, or federal government programs to provide assistance to patients who have no or limited ability to pay for their health care. The specialist will counsel and educate patients on available financial resource options and assist patients with the Presumptive Eligibility process to ensure they have secured a financial resource in place to pay for their health care. The specialist will keep up to date with insurance plans and payers to appropriately counsel patients on their health care financial responsibilities and work with patients and insurance companies to resolve complicated billing and denial issues.
Responsibilities
Follows and administers all Mercyhealth financial policies and guidelines, in-depth knowledge of collection laws and the bad debt process.
Maintains thorough knowledge base of registration and cash drawer process.
Frontline workflows for payment posting, cash drawer balancing and cash compliance policies.
Researches and performs audits on patient accounts to determine balances due.
Counsels patients on billing concerns, account balances, services costs/estimates and insurance resources.
Establishes payment plans with patients and follows up on payment arrangements.
Processes refunds and pay in full discounts.
Communicates with physicians, patient care staff and hospital/clinic reception regarding out of network insurance status, medical urgency and other billing/insurance issues.
Verifies accuracy of patient accounts using billing system and review patient accounts for accuracy.
Initiates follow-up with patients, billing department, coding department and insurance companies to ensure payment for services.
Understands managed care contract reimbursement rates and associated terminology.
Manages government and commercial insurance reimbursement rates.
Maintains extensive knowledge of programs offered through government, marketplace, Care Credit, foundation grants and other financial resource options.
Assists patients in obtaining copay and drug replacement assistance for services provided.
Screens patients for charity care application completion and self-pay patients for presumptive eligibility for Medicaid.
Completes insurance eligibility, benefit verification and pre-certifications as required.
Monitors patient work queues and resolves outstanding balance issues.
Contacts patients with self-pay balances to collect payment and provide assistance with financial resources.
Responds to patient inquiries via in person, mail, phone and email.
Accounts for third party and patient requests on credit balances and initiates refund process.
Acts as a liaison between the patient, payors and Mercyhealth partners.
Meets department guidelines for daily patient contact, collection goals and benchmarks.
Maintains documentation standards on patient encounters and ensures account status is accurate.
Performs high level service recovery to resolve patient concerns and manages complaints and grievances.
Researches denied claims through system/account/process to reconcile information and manages access to multiple insurance websites.
Uses good judgment in highly emotional and demanding situations.
Reacts to frequent changes in duties and volume of work.
Manages multiple tasks with ease and efficiency and works independently with minimal supervision.
Provides training and mentoring and participates in educational programs to meet mandatory requirements and identified personal growth needs.
Performs other duties as assigned.
Education And Experience Graduate of high school preferred Two years customer service and/or collections experience. Knowledge of reimbursement practices for commercial and government payers preferred. Medical terminology preferred.
Skills And Abilities Excellent oral and written communication skills and organizational skills. Strong problem-solving skills. Knowledge of various health care systems and databases desirable. Knowledge of general computer applications (Word, Excel, Outlook, etc.). Ability to multitask and prioritize tasks accordingly. Ability to handle challenging conversations professionally.
Benefits
Comprehensive Benefits Package with retirement plan, competitive medical, dental and vision insurance options, life and disability coverage, and flexible spending plans.
Competitive Compensation and shift differential and special pay incentive programs.
Paid Time Off plan that increases with milestone anniversaries.
Career Advancement opportunities and educational assistance programs.
Employee Wellbeing focus with health risk assessment and Wellbeing mobile application.
Additional benefits including employee assistance programs, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services and financial education.
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Financial Resource Specialist
role at
Mercyhealth Wisconsin and Illinois
Overview The Financial Resource Specialist position requires extensive knowledge of Mercyhealth financial guidelines, collection policies, and government regulations related to billing and collections. The specialist will embody the hospital's mission, vision and values and liaison with clinic and hospital locations to ensure financial policies are adhered to. The specialist will greet patients or family members in clinic and hospital settings and assist with questions regarding insurance coverage, financial assistance, billing or payment options. The specialist will have knowledge of revenue department from registration through collection, billing, coding and denial processes and a comprehensive knowledge base of community, state, or federal government programs to provide assistance to patients who have no or limited ability to pay for their health care. The specialist will counsel and educate patients on available financial resource options and assist patients with the Presumptive Eligibility process to ensure they have secured a financial resource in place to pay for their health care. The specialist will keep up to date with insurance plans and payers to appropriately counsel patients on their health care financial responsibilities and work with patients and insurance companies to resolve complicated billing and denial issues.
Responsibilities
Follows and administers all Mercyhealth financial policies and guidelines, in-depth knowledge of collection laws and the bad debt process.
Maintains thorough knowledge base of registration and cash drawer process.
Frontline workflows for payment posting, cash drawer balancing and cash compliance policies.
Researches and performs audits on patient accounts to determine balances due.
Counsels patients on billing concerns, account balances, services costs/estimates and insurance resources.
Establishes payment plans with patients and follows up on payment arrangements.
Processes refunds and pay in full discounts.
Communicates with physicians, patient care staff and hospital/clinic reception regarding out of network insurance status, medical urgency and other billing/insurance issues.
Verifies accuracy of patient accounts using billing system and review patient accounts for accuracy.
Initiates follow-up with patients, billing department, coding department and insurance companies to ensure payment for services.
Understands managed care contract reimbursement rates and associated terminology.
Manages government and commercial insurance reimbursement rates.
Maintains extensive knowledge of programs offered through government, marketplace, Care Credit, foundation grants and other financial resource options.
Assists patients in obtaining copay and drug replacement assistance for services provided.
Screens patients for charity care application completion and self-pay patients for presumptive eligibility for Medicaid.
Completes insurance eligibility, benefit verification and pre-certifications as required.
Monitors patient work queues and resolves outstanding balance issues.
Contacts patients with self-pay balances to collect payment and provide assistance with financial resources.
Responds to patient inquiries via in person, mail, phone and email.
Accounts for third party and patient requests on credit balances and initiates refund process.
Acts as a liaison between the patient, payors and Mercyhealth partners.
Meets department guidelines for daily patient contact, collection goals and benchmarks.
Maintains documentation standards on patient encounters and ensures account status is accurate.
Performs high level service recovery to resolve patient concerns and manages complaints and grievances.
Researches denied claims through system/account/process to reconcile information and manages access to multiple insurance websites.
Uses good judgment in highly emotional and demanding situations.
Reacts to frequent changes in duties and volume of work.
Manages multiple tasks with ease and efficiency and works independently with minimal supervision.
Provides training and mentoring and participates in educational programs to meet mandatory requirements and identified personal growth needs.
Performs other duties as assigned.
Education And Experience Graduate of high school preferred Two years customer service and/or collections experience. Knowledge of reimbursement practices for commercial and government payers preferred. Medical terminology preferred.
Skills And Abilities Excellent oral and written communication skills and organizational skills. Strong problem-solving skills. Knowledge of various health care systems and databases desirable. Knowledge of general computer applications (Word, Excel, Outlook, etc.). Ability to multitask and prioritize tasks accordingly. Ability to handle challenging conversations professionally.
Benefits
Comprehensive Benefits Package with retirement plan, competitive medical, dental and vision insurance options, life and disability coverage, and flexible spending plans.
Competitive Compensation and shift differential and special pay incentive programs.
Paid Time Off plan that increases with milestone anniversaries.
Career Advancement opportunities and educational assistance programs.
Employee Wellbeing focus with health risk assessment and Wellbeing mobile application.
Additional benefits including employee assistance programs, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services and financial education.
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