Reimbursement Specialist HME-Full time-Dubuque

Trinity Health•Dubuque, IA

39d•Onsite

About The Position

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 Dubuque is the leading hospital in the tri-states, offering the only comprehensive cardiology center and Level II regional neonatal intensive care unit in the area as well as the newly constructed MercyOne Dubuque Cancer Center. Other services include a trauma center, a CARF-accredited inpatient rehabilitation unit, orthopedics, retail pharmacies, palliative care and a wide range of outpatient and community services. MercyOne operates two hospital-based skilled nursing units and a 40-bed nursing home. In recognition of the strength of its nursing service and the overall quality of patient care, MercyOne Dubuque has been designated a Magnet hospital four consecutive times – the nation’s most prestigious award for nursing excellence. Join the MercyOne Family! We are looking to hire a Reimbursement Specialist As a Reimbursement Specialist at MercyOne , you will be 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.

Requirements

High school graduate or equivalent.
Medical terminology background preferred.

Nice To Haves

Prefer 1-2 years’ experience in billing and/or accounts receivable work.
Prefer background in homecare or another related medical/health field.
Prefer background/experience in medical equipment receivables including HME reimbursement/coverage and regulatory standards.

Responsibilities

Performs all related accounts receivable tasks utilizing appropriate policies , guidelines, and standards.
Ensures compliance with regulatory bodies such as CMS, The Joint Commission, and others.
Ensures charges are valid and meet the payers’ coverage criteria and documentation requirements prior to generating a claim/invoice.
Prepares and submits all paper claims in a timely manner .
Performs follow-up and resolution of all charges rejected at the front-end edits for charges submitted electronically.
Responds to accounts receivable inquiries/issues and performs assigned tasks and research in a timely , professional manner.