Employment Type:

Full time

Shift:

Day Shift

Description:

At MercyOne, health care is more than just a doctor’s visit or a place to go when you’re in need of medical attention. Our Mission is based on improving the health of our communities – that means not only when you are sick but keeping you well.

MercyOne Central Iowa sets the standard for personalized and radically convenient care in the Des Moines metro area and surrounding counties. MercyOne Des Moines Medical Center, founded by the Sisters of Mercy in 1893, is the longest continually operating hospital in Des Moines and Iowa’s largest medical center, with 802 beds available. The hospital is one of the Midwest’s largest referral centers.

With more than 7,000 colleagues and a medical staff of almost 1,500 physicians and allied health professionals, MercyOne Central Iowa is one of Iowa’s largest employers.

Want to learn more about MercyOne Des Moines? Click here: https://www.mercyone.org/desmoines/find-a-location/

Join the MercyOne Family! We are looking to hire a Billing Specialist.

As a Billing Specialist at MercyOne, you will provide coding, charge entry, insurance expertise, registration, and customer service to assist the laboratory department and patient and/or client through the revenue cycle for hospital and outreach accounts.

• Maintains functional knowledge of charge entry, CPT, and ICD-10 changes, coding practices, and insurance terminology.

• Enters daily department charges, credit or add charges.

• Daily monitoring reports for appropriate charging, coding/modifiers, transferring charges, correcting charges, reconciling charges, following up on delinquent reports, and problem solving with staff.

• Responsible for continually reviewing requirements for Medicare and other payors to assure all applicable rules and regulations are being satisfied. Verifies that the diagnosis codes and corresponding laboratory tests meet the medical necessity criteria to assure claims are paid on the first submission. Work with ordering personnel, including physician’s office staff, to resolve any discrepancies and provide education.

• Responsible for updating patient registrations as needed by utilizing hospital and laboratory policies and procedures.

• Monitors billing denials to determine need for pre-authorization on specific tests. Communicates needed pre-authorization requirements to appropriate departments and/or clients. Investigates denials for correction and/or trends.

• Assures all areas of department maintain compliance to applicable billing and coding rules and regulations.

• Keeps abreast of insurance carrier rules and changes by participating in carrier specific education opportunities and email notifications.

• Develops procedures and protocols for laboratory billing.

• Conducts audits on a routine basis on billing practices and adjusts policy accordingly.

• Serves as a liaison between the department, patient accounts, patient access, coding, medical records, and the client.

• Meets charge posting deadlines and timely reviews/resolves accounts holding for review/additional information/correction.

• Understands and utilizes computer billing system and maintains knowledge of industry regulations as related to hospital-based billing and outreach laboratory billing.

• Acts as resource for billing system functionality, and identifies billing questions/concerns, pursuing and communicating resolution, as appropriate.

• Serves as a patient advocate in promoting clarity and understanding to efficiently and courteously answer client phone calls regarding billing, pricing and CPT codes.

Schedule: Monday-Friday 8am-4:30pm

General Requirements:

• One year experience with healthcare billing and coding preferred. Experience in accounts receivable or banking also considered.

• Laboratory billing experience preferred.

• Basic knowledge of third party payor, insurance, and regulatory requirements preferred.

• Working knowledge of computer information systems that utilize several computer applications concurrently.

• Proof of completion of Mandatory Reporter abuse training for child and dependent adult abuse within three (3) months of hire.

Education:

• High School or GED required.

• Associates Degree or Bachelor’s degree preferred.

Colleagues of MercyOne Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout the system!

Visit MercyOne Careers (https://www.mercyone.org/careers/) to learn more about the benefits, culture, and career development opportunities available to you at MercyOne Health System circle of care.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is 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, status as a protected veteran, or any other status protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran