Ld Spec Infusion Acct Coord (Non-Exempt) - 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 Specialty Account Coordinator Team Lead is responsible for multiple facets of patient account coordination including insurance and benefit verification, denials management, patient assistance, and collections.
• In addition to account coordination, the Specialty Account Coordinator Team Lead is also responsible for reviewing documented clinical information and test results in order to determine whether or not the treatment(s) ordered for the patient meets the medical necessity criteria outlined in the insurance companys coverage policy and/or in the case of chemotherapy, the regimen is compliant with NCCN guidelines.
• The Specialty Account Coordinator Team Lead is also responsible for providing training to new and existing staff on policies, protocols, systems, standards, techniques and communicating clear instructions to the team as the liaison to management.
• The Specialty Account Coordinator Team Lead is a resource and content expert to the Specialty Account Coordinator team for assistance with reviewing medical records for clarification and/or additional information when policy or NCCN guidelines are not adhered to or for identifying and confirming treatment requests that do not meet medical necessity requirements.
• In those cases, the Specialty Account Coordinator Team Lead will advise providers when a peer to peer review is necessary and facilitate that communication process.
• The Specialty Account Coordinator Team Lead will assist and instruct the Specialty Account Coordinator team with appeal writing, provide guidance for correcting outpatient infusion claims which have rejected or denied and is responsible for knowing which assistance programs, suchas drug copay cards that patients may qualify for, assisting patients in enrolling in thoseprograms, monitoring services rendered, billing the assistance programs for the applicable funds and conducting random quality control checks on all aspects of work produced by the team.
• This position requires the ability to contribute to the continued growth of employees to meet departmental needs as well as a thorough understanding of claims procedures and insurance company regulations.
• It requires monitoring of insurance company regulations for changes in pre-certification, documentation, or claims submission requirements.
• It also requires accuracy, attention to detail and the ability to communicate well with physicians, staff, patients, and insurance companies.
• The Specialty Account Coordinator Team Lead also serves as a contact for other staff and patients and always performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.

Qualifications:

• Minimum Qualifications: Education: Some college hours in business, finance and/or accounting related courses preferred.
• Experience: A minimum of 5 years related experience required.
• Other skills & knowledge (skills, knowledge, abilities):- Interpersonal, organizational and analytical skills required.- Must possess ability to work in stressful situations, meet deadlines and perform daily responsibilities with consistent accuracy.
• Ability to use logic, good judgment and be able to rapidly identify and initiate corrective action when problems arise.
• Must be able to communicate effectively providing good written and oral direction to co-workers.
• Must be able to work collaboratively with VBO management and co-workers in demanding situations.

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!

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.

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