Pre-Service Coordinator

Mercycare; Cedar Rapids (IA); On-site; USD 25,000 - 39,000; Full time

Job summary

Mercycare in Cedar Rapids, IA is seeking a Revenue Cycle Associate to support patient-centered care by communicating with insurers to determine benefits and obtain pre-certifications, and by informing patients of liable amounts after pre-service steps are completed.

The role collaborates with on-site case management, clinical staff, and the billing team to ensure accurate eligibility checks, authorizations, and revenue cycle improvements, contributing to a positive patient experience and

Qualifications

• One-year related experience in hospital, clinic, medical office, business services/revenue cycle.
• Experience with patient billing and insurance communication is preferred.
• Knowledge of HIPAA and medical terminology is desirable.

Responsibilities

• Prepare and clear new cases for pre-scheduled services and verify benefits.
• Interact with insurance companies to verify benefits and obtain authorizations.
• Communicate patient liability and ensure pre-service processes are completed.
• Develop and maintain revenue cycle reports and assist in improving billing processes.
• Follow safety guidelines and collaborate with care teams.

Skills

Strategic thinking

Business judgement

Communication

Education

High School Diploma

Job description

Work Shift Day/Evening Scheduled Weekly Hours 40 Summary This position supports Mercy's philosophy of patient centered care by assisting patients by communicating with insurance payors, via various methods (i.e. telephone, fax, internet) to determine eligible benefits (full coverage, medical policy determination) and acquiring pre-certification when deemed necessary by the insurance payor. Will also be responsible for communicating the liability to the patient after ensuring the pre-service process has been completed in advance of the patient's arrival for scheduled services.

Job Description Job Duties

Prepares, validates and completes all step necessary to clear new cases for pre-scheduled services. This includes but is not limited to validating and gathering insurance and demographic information. Interacts with insurance companies via website, phone, or fax to verify benefits, obtain authorizations, identify insurance guidelines, and facilitate communication. Gathers information to verify benefits and benefits eligibility by utilizing the Epic system. Completes and/or obtains all necessary authorizations for the service(s) to be performed. Works with clinical providers, on-site case management team, as well as team members LPN/RN or Nurse Auditor in the Prior Authorization or CDI department. Performs Pre-Service collection estimation functions and communicates patient liability with patient. Provides point of service information and logistics to ensure an exceptional patient experience. Assumes responsibility for revenue cycle management and is key in developing processes with hospital department heads to maximize and enhance revenue/reimbursement for services provided. Provides leadership in billing to improve transactional accuracy. Develops and maintains reports and statistical information on a timely monthly basis. Other related duties as required. Follows Mercy's safety guidelines, carries out job-specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries.

Knowledge, Skills and Abilities

Excellent strategic skills and overall business judgement; the ability to visualize and implement strategies required to be successful in accounts receivable management and translate this vision into a meaningful specific plan that includes performance improvement in the billing process, is compliant with HIPAA regulation and maximizes payment accuracy. A professional demeanor and communication style that fosters credibility with staff, senior management, physicians, department heads, the community, and customers. A style that enhances and promotes the ability to operate in an entrepreneurial, fast-moving environment and the ability to function as part of a high-level management team where requirements are to produce results and be responsive to our customers. The ability to create, mold and build a successful accounts receivable management program. Promote a high degree of interpersonal astuteness, personal integrity, compassion and the ability to gain the trust of department heads, business services staff, physicians, senior management, and the Senior Vice President of Finance.

Professional Experience Required:

One-year related experience in hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service.

Education

High School Diploma or equivalent required.

Licensure, Certification, Registration Preferred:

CRCR certification with HMFA or equivalent.

Physical Requirements

Sedentary: Exert up to 10 lbs. of force occasionally and/or a minute amount frequently

Pay Rate Type Hourly

Pay Rate Type Hourly Mercy is an independent, community-based organization supporting the Cedar Rapids area for over 120 years.

Equal Opportunity Employer

Mercy is an equal-opportunity employer. We value diversity, equity, and inclusion and therefore evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status, and other legally protected characteristics.