Job Description
Billing Specialist Essential duties and responsibilities include: Following and administering all Mercyhealth financial policies and guidelines. Maintaining a thorough knowledge base of the registration and cash drawer process. Following all necessary frontline workflows in regard to payment posting, cash drawer balancing and adhering to all cash compliance policies. Researching and performing audits on patient accounts to determine where balances are due, from third party payers or patient responsibility. Meeting with patients in person or via telephone to counsel patients/customers on billing concerns, account balances, services costs/estimates, and various insurance resources. Establishing payment plans with patients and following up on broken payment arrangements when appropriate. Researching patient accounts, processing refunds, and pay in full discounts. Communicating with physicians, patient care staff and hospital/clinic reception regarding out of network insurance status, medical urgency, and other patient billing/insurance issues. Thorough understanding of how to identify if charges are correct. In depth understanding of what information is available to assist in the process, such as the medical record, chart view, MPI, billing, and coding reviews as appropriate. Navigating the billing system and reviewing patient accounts for accuracy. Initiating appropriate follow-up with patients, billing department, coding department, and insurance companies to ensure payment for services. Familiar with managed care contract reimbursement rates. Understanding terminology associated with contracts as well as familiar with terminology and calculations used on a payment voucher and patient's explanation of benefits. Understanding governmental and commercial insurance reimbursement rates. Maintaining an extensive kn