||Job Summary:Under the direction of the Supervisor of Billing, the Reimbursement Technician is responsible for the billing and reimbursement process of the Patient Accounts Department. Responsibilities include reviewing and editing UB92's and HCFA 1500's within the electronic billing system on a daily basis. This process must be HIPAA compliant as well as follow the standards set by the third party payers. The position must also answer patient and third party inquiries, as needed. The incumbent performs duties and tasks in accordance with performance standards established for the job. The incumbent may have access to highly confidential patient, employee and/or Mercy proprietary information, and must handle & protect the information in accordance with hospital & system policies, HIPAA requirements and the highest level of ethical standards. The incumbent is responsible for reporting all security events, potential events, or other security risks to the organization. The incumbent is responsible for participation in and completion of all patient safety initiatives appropriate to the position, and conducts all job responsibilities according to the Mission and Values of Mercy Hospital.Requirements:A High School Diploma with post-secondary training in accounting or bookkeeping is desired. An Associates degree in accounting or bookkeeping is preferred. Medical Terminology required. A minimum of one (1) year experience in this or similar jobs is required. Additional experience with progressively more responsible tasks is desired. Experience in a healthcare and/or not for profit environment is preferred. Must be able to operate independently to complete all tasks with minimal supervision. Must have good interpersonal skills to interact with individuals in all levels of the hospital and the public. Must have good organizational skills and be able to manage multiple tasks at the same time. Must have an awareness of financial subsystems and their relationship to general ledger. Must be accountable for accuracy and timeliness of work. Must be trustworthy and committed to confidentiality. Incumbent has access to confidential hospital, patient, and employee financial information.Principal Responsibilities:1. Completes each of the following daily activities in the reimbursement area.· Reviews, edits, and finalizes patient billing documents for respective payers.· Files records, reports, and other documentation in a systematic and readily retrievable manner.· Reviews billing documents for all payers (including commercial, state, federal, third party, and workers compensation) for each of the following features: a) Accuracy of contentb) Completeness of preparationc) Quality of preparationd) Designation of appropriate payer2. Reviews all remittances received by Patient Accounts on a weekly basis.· Each remittance (Medicare, Medicaid, Blue Cross, Aetna, etc.) must be reviewed for denials.· Each EOB must be reviewed upon receipt for any denials or inappropriate payments.· All denials must be appealed, resubmitted, or reprocessed by the insurer.3. Resolves questions, issues, and problems related to reimbursement inquiries.· Answers patient inquiries in person, by telephone, or via written correspondence, as appropriate.· Follows up with appropriate payers to resolve problems and answer questions related to reimbursements.· Provides feedback related to reimbursements to billing services and/or to patient registration and HIS as needed.· Works cooperatively with hospital staff, departments, and patients to identify and resolve billing and reimbursement discrepancies.4. Maintains a positive attitude and promotes a professional environment.· Maintains a positive attitude daily within the Patient Accounts Department.· Promotes a positive work environment.· Continually engages in a teamwork setting.· Works well with others in the Patient Accounts Department.· Behavior is acceptable for a professional environment.5. Performs additional duties as required or assigned.
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