PFS Auditor & Denials Specialist (Hybrid)

Mercy-Health-System-Corporation; Janesville (WI); Hybrid; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Life & Disability Insurance

Paid time off

Parental and caregiver leave

Tuition reimbursement

Employee Discounts

Job summary

Mercyhealth in Wisconsin is seeking a Patient Financial Services professional to audit and resolve patient accounts, focusing on payer accuracy and timely billing. You will work in a hybrid schedule and handle SBO and Epic workflows with strong attention to HIPAA, privacy, and compliance.

The role emphasizes Excel-based data entry, denials management, and coordination with payers, attorneys, and patients to resolve balances and refunds as needed.

Qualifications

• Auditing patient accounts for correct payer billing.
• Understand collection laws for workers' compensation and third party liability.
• Becomes fluent in the Single Billing Office environment within Epic SBO.
• Know SBO billing practices and hospital/clinic billing requirements.
• Respond to inquiries from patients, payers, attorneys, and vendors.

Responsibilities

• Research and perform audits on patient accounts to verify correct balances and payer assignments.
• Identify and resolve denials and disputed claims with payers.
• Draft appeal letters per payer requirements when needed.
• Obtain medical records as required for workers' compensation and TPL claims.
• Maintain HIPAA compliance and document all encounters accurately.

Skills

Microsoft Excel

Healthcare billing

Typing / data entry

Organizational skills

Customer service

Medical terminology

Education

High school diploma or equivalent

Tools

Epic SBO

Agility

Connex

Kronos

OneSource

Microsoft Word

Microsoft Outlook

Claim source

On-Base

Job description

Mercyhealth in Wisconsin is seeking a Patient Financial Services professional to audit and resolve patient accounts, focusing on payer accuracy and timely billing. You will work in a hybrid schedule and handle SBO and Epic workflows with strong attention to HIPAA, privacy, and compliance.

The role emphasizes Excel-based data entry, denials management, and coordination with payers, attorneys, and patients to resolve balances and refunds as needed.