Patient Account Rep- Diversified Business-Hybrid

Mayo Clinic•Rochester, MN

3d•Hybrid

About The Position

This is a hybrid position and must be located within 100 miles of any of the Mayo Clinic campuses for on-site expectations based on business needs. The role serves as an institutional insurance and reimbursement expert for one or more business lines including outpatient pharmacy, durable medical equipment, skilled nursing facility, home health agency, or continuing care retirement center. The representative performs all aspects of the billing and collection processes for these business lines across the enterprise. This includes service pre-certification, insurance coverage review, personal responsibility determination, communication with patients, claim submissions, denial review, rebilling, appeals, and accounts receivable management. The role requires strong problem-solving, customer service, and communication skills (verbal and written) to interact with patients and internal customers to resolve account, billing, and payment issues. The representative will also interpret, apply, and communicate Mayo Clinic policies regarding the financial aspects of patient care to ensure optimal reimbursement for both the patient and Mayo Clinic.

Requirements

Associate Degree in finance, business, or healthcare-related majors and 1 year of experience in medical, pharmacy, or durable medical equipment billing and collection activities OR High School diploma/GED with at least 3 years of experience in medical, pharmacy, or durable medical equipment billing and collection activities, or certified pharmacy tech with 2 years of experience.
Must possess strong human relations, communication, problem-solving, and organizational skills.
Ability to interact with a variety of customers and personnel, both within and outside the institution.
Must be able to work independently and in a team environment.
Experience working with Windows-based software, Microsoft Word, Excel, and the Internet.
Keyboarding experience required.

Nice To Haves

Pharmacy experience and submitting prior authorizations.
CPHT, MAA, or LPN preferred.
Claims management software experience desired.
Healthcare Financial Management Association (HFMA) Certification Preferred.

Responsibilities

Performs all aspects of the billing and collection processes for individual business lines across the enterprise.
Conducts service pre-certification.
Reviews insurance coverage and determines personal responsibility.
Communicates with patients regarding their accounts.
Submits claims.
Reviews claim denials.
Rebills claims.
Handles claim appeals.
Manages accounts receivable.
Utilizes problem-solving, customer service, and communication skills in interactions with patients and internal customers.
Resolves account, billing, and payment issues for patients, physicians, nurses, pharmacists, technicians, and social workers.
Interprets, applies, and communicates Mayo Clinic policies regarding financial aspects of patient care.
Assures optimal reimbursement for both the patient and Mayo Clinic.