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Company: Mercy
Location: Dexter, MO
Career Level: Associate
Industries: Healthcare, Pharmaceutical, Biotech

Description

Insurance Services Rep I

Overview:

Productivity - Maintains daily work assigned to assure low A/R days. -

Maintains or exceeds productivity standards on a daily, weekly, monthly basis- Maintains a current status of work queue and follows up in a timely manner. - Completes assignments in the prescribed time periods and with efficiency and attention to detail.Quality. 

Maintains acceptable quality standards per department requirements. -

Effective and efficient troubleshooting of underpaid and denied claims- Communicates effectively with co-workers/third party payers to successfully resolve outstanding insurance receivables. -

 Accurately and efficiently processes the account including transaction recording, claim corrections and other functions.

Communication- Works effectively with other staff members to accomplish work and departmental projects.- Interacts by telephone with other departments, physician offices and third party payers.-

Demonstrates positive and professional communications skills.System Proficiency -

Uses and demonstrates a understanding of the patient accounting computer system.-

Maintains technical knowledge and skills of all computer applications, including but not limited to EPIC, SSI, Microsoft Office, and third party insurance applications.- Maintains current EPIC/Systoc proficiency level for applicable role (EUPA = End User Proficiency Assessment).Knowledge - Stays abreast of contract, regulatory, procedural and other changes affecting the department.- Demonstrates an understanding of UB04/CMS1505 claim forms and corresponding date elements.- Demonstrates an understanding of third party requirements/regulations which allows effective job performance.- Demonstrates an understanding of hospital and physician reimbursement methodologies- Strong understanding of HIPPA laws.Mission Performs duties consistent with the mission, values and Mercy Service Standards.MiscellaneousPerforms other duties as assigned.

 

Qualifications:

  • HS Degree 
  • Other Skills :Basic Microsoft Excel and Word knowledge. Communication and customer service skills


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