Job Overview

Employment Type:

Full time

Shift:

Description:

POSITION PURPOSE

This position is responsible for all processes relating to the submission and payment of charges for assigned accounts. This includes reviewing and making necessary corrections prior to billing, preparing, and submitting the hardcopy claims generated from Brightree, responding to and resolving all requests for information concerning the receivables, reviewing and addressing partial payments and denials, and reviewing and resolving outstanding receivables not paid in a timely manner. Responds to accounts receivable inquiries/issues and performs assigned tasks and research in a timely, professional manner. Customers include clients, families, third party payers, physicians, referral sources, community, home medical equipment and hospital staff.

ESSENTIAL FUNCTIONS

1.    Performs all related accounts receivable tasks utilizing appropriate policies, guidelines, and standards.

2.    Ensures compliance with regulatory bodies such as CMS, The Joint Commission, and others.

3.    Ensures charges are valid and meet the payers’ coverage criteria and documentation requirements prior to generating a claim/invoice.

4.    Prepares and submits all paper claims in a timely manner.

5.    Performs follow-up and resolution of all charges rejected at the front-end edits for charges submitted electronically.

6.  Reviews and resolves all written requests for additional information, all partial payments and all denials that are related to the accounts receivable issues.

7. Researches and responds to questions, concerns from customers and third-party payers regarding issues concerning accounts receivable issues.

8.  Works the Aged Balance Report for outstanding receivable not paid within 60 days and perform necessary follow-up or activity required to resolve the outstanding receivables.

9.  Assures that all receivables are paid or adjusted in a timely manner.

10.  Assists management to meet targeted operational benchmarks and quality indicators.

11.  Participates in orientating, educating, and mentoring staff.

12.  Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

MISSION STATEMENT AND CORE VALUES

Mission Statement:  We, MercyOne Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.

Core Values:

•    Reverence:  We honor the sacredness and dignity of every person.

•    Commitment to Those who are Poor:  We stand with and serve those who are poor, especially those most vulnerable.

•    Safety: We embrace a culture that prevents harm and nurtures a healing, safe environment for all. 

•    Justice:  We foster right relationships to promote the common good, including sustainability of Earth.

•    Stewardship:  We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care.

•    Integrity: We are faithful to those we say we are.

MINIMUM QUALIFICATIONS

1.    High school graduate or equivalent. 
 
2.    Prefer 1-2 years experience in billing and/or accounts receivable work.

3.    Prefer background in homecare or other related medical/health field.

4.    Prefer background/experience in medical equipment receivables including HME reimbursement/coverage and regulatory standards.

5.    Medical terminology background preferred. 

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

1.    During an 8-hour shift, may sit 7 hours, and stand/walk ½ hour each.

2.    Requires occasional bending, stooping, reaching, pushing, and pulling.

3.    Requires use of hands for simple and firm grasping, fine manipulation, and repetitive motion work (typing, data entry).

4.    Must be able to maintain high level of concentration with many interruptions and attain expected deadlines.

5.    May require some lifting/carrying objects up to 20 pounds.

6.    Must be able to speak, hear speech, and see at near visual acuity level.

7.    Must possess the ability to comply with Trinity Health policies and procedures.  

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.