Patient Financial Services Follow Up

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Mercyhealth Wisconsin and Illinois

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1889

🛡️ Insurance

💼 Consulting

🏨 Hospitality

Insurance • Consulting • Hospitality

Mercyhealth Wisconsin and Illinois is a regional integrated health system providing hospitals, outpatient clinics, urgent care, specialty care (cardiology, oncology, orthopedics, neurosurgery, etc. ), pharmacies, home health and hospice services across northern Illinois and southern Wisconsin. It operates MercyCare Health Plans (commercial health insurance), offers graduate medical education and fellowship/residency programs, runs a foundation and community health initiatives, and provides patient-facing resources such as MyChart, online scheduling, and wellness programs.

📋 Description

• Verifies claims are received by the payer and follows up to obtain payment via phone calls, portal or website use. • Reviews claim adjustment reason codes or explanations of benefits received by the payer for appropriate follow-up. • Evaluates next steps and takes action to call payer, follows up with a resubmission or dispute as required. • Drafts an appeal or complete reconsideration forms according to payer requirements. • Obtains and sends medical records during the appeals process when needed. • Calls patients or payers directly to obtain needed information to resolve an account balance. • Identifies trends with payor rejections or denials and escalates these trends to leads/supervisors. • Uses computer systems/technology to locate claims information to resolve account balances. • Maintains compliance with patient financial services policies and procedures. • Researches accounts that are denied for No Authorization as a priority to appeal or escalate.

🎯 Requirements

• High school diploma or equivalent • Microsoft Excel required • Healthcare billing experience preferred • Basic understanding of working in multiple software applications at the same time • Basic business writing skills

🏖️ Benefits

• Medical • Dental • Vision • Life & Disability Insurance • FSA/HSA Options • Generous, accruing paid time off • Paid Parental and caregiver leave • Career advancement and educational opportunities • Tuition and certification reimbursement • Certification Reimbursement • Well-being Programs • Employee Discounts • On-Demand Pay • Financial Education • Annual recognition/awards events • Partner appreciation days • Family entertainment/attractions discount • Community service/improvement opportunities