What are the responsibilities and job description for the Audit & Denials Revenue Specialist position at Mercy?
We’re a Little Different
Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.
At Mercy, we believe in careers that match the unique gifts of unique individuals – careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its “Top 100 Places to Work.”
Overview:
The Payor Audits & Denials Financial Specialist will possess and apply thorough knowledge of collections and the ability to apply the knowledge to all aspects of a patient account that is involved in the audit and appeals process to accurately complete accounts receivable reconciliation.
Qualifications:
- Education: High school diploma or equivalent certification.
- Experience: A minimum of two years’ experience as a medical reimbursement specialist, healthcare insurance collector, patient account representative or medical collector.
- Preferred Certifications: Certified Revenue Cycle Representative (CRCR), Certification in Healthcare Compliance (CHC)
- OTHER SKILLS & KNOWLEDGE
- Strong understanding of insurance terms, payer reimbursement methodology, and contract language including but not limited to Medicare, Medicaid, Commercial and Managed Care.
- Knowledge of medical terminology.
- Strong understanding of pricing methodologies for supplies, orthotics, prosthetics, and implantable devices.
- Knowledge of Medicare, Medicaid and Commercial payer healthcare reimbursement methodologies.
- Comprehensive understanding of medical contract reimbursement terms.
- Excellent written and oral communication skills.
- Skilled in identifying medical billing discrepancies and healthcare trends.
- Ability to self-manage and prioritize work assignments.
- Experience collecting money from commercial insurance.
- Advanced computer skills, specifically Word, Excel and Outlook required.
- Excellent critical thinking skills and an inquisitive nature.
- Strong organizational skills as well as great attention to detail.
- Ability to multi-task and work with little direction.
- Excellent interpersonal, communication and organizational skills to effectively work with others involved in the audit and appeal process.
- Must possess the ability to prioritize, delegate, and organize various tasks/projects simultaneously to ensure departmental and Mercy-wide goals are timely met.
- Ability to maintain confidentiality when working with sensitive information.
- Ability to stay current on changing governmental regulations.
- Ability to work independently to accomplish and carry out goals/objectives in a collaborative manner.
- Very high personal integrity and work ethic with the ability to demonstrate and obtain.
- Ability to travel periodically across the Ministry as required.
We Offer Great Benefits:
Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period!
- Recruiter to enter incentive information: Mercy Quick Links, Community Links, etc. If nothing to add, delete this bullet under “We Offer Great Benefits” before posting.
We’re bringing to life a healing ministry through compassionate care.
At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We’re expanding to help our communities grow. Join us and be a part of it all.
What Makes You a Good Match for Mercy?
Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We’re also collaborative and unafraid to do a little extra to deliver excellent care – that’s just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.
