Credit Specialist - Mercyhealth

Overview:Responsible for resolving all credit balances on patient accounts in the hospital and physician billing systems, which may result in issuing a refund to a third party payer and/or patient, or an unclaimed property submission. Performs other duties as assigned.Responsibilities:

Essential Duties and Responsibilities

• Works with appropriate revenue cycle staff when performing account resolution functions
• Investigates and researches credit and undistributed balances on hospital and physician accounts, working those balances through to resolution
• Initiates refund requests as appropriate to third party payers and/or patients, which includes obtaining appropriate documentation and accurately recording proper refund information into the hospital or physician billing system
• Identifies unclaimed property amounts and initiates the unclaimed property process
• Reviews patient accounts for possible reversal of administrative, courtesy, or contractual adjustments
• Maintains a working knowledge of common billing and account resolution practices and requirements for hospital and/or clinic billing
• Communicates with insurance and/or patients as appropriate during the resolution process
• Keeps updated on applicable payer policies, federal and state regulations, laws, and procedures
• Maintains productivity standards as outlined in the Revenue Cycle department
• Special projects as assigned.

Culture of Excellence Behavior Expectations

To perform the job successfully, an individual should demonstrate the following behavior expectations:

Quality - Follows policies and procedures; adapts to and manages changes in the environment; Demonstrates accuracy and thoroughness giving attention to details; Looks for ways to improve and promote quality; Applies feedback to improve performance; Manages time and prioritizes effectively to achieve organizational goals.

Service - Responds promptly to requests for service and assistance; Follows the Mercyhealth Critical Moments of service; Meets commitments; Abides by MH confidentiality and security agreement; Shows respect and sensitivity for cultural differences; and effectively communicates information to partners; Thinks system wide regarding processes and functions.

Partnering - Shows commitment to the Mission of Mercyhealth and Culture of Excellence through all words and actions; Exhibits objectivity and openness to other's views; Demonstrates a high level of participation and engagement in day-to-day work; Gives and welcomes feedback; Generates suggestions for improving work: Embraces teamwork, supports and encourages positive change while giving value to individuals.

Cost - Conserves organization resources; Understands fiscal responsibility; Works within approved budget; Develops and implements cost saving measures; contributes to profits and revenue.

Education and Experience

High school diploma or equivalent required. Two years of Revenue Cycle experience with emphasis in billing or collections preferred.

Certification and Licensure

N/A

Skills and Abilities
Proven ability to work effectively in a team environment.
Strong typing/data entry experience.
Strong organizational skills and attention to detail, accuracy and follow-through.
Knowledge of medical terminology preferred.

Special Physical Demands

The Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand; walk; climb; or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Level of Supervision

N/A

Supervises

N/A