Thank you for considering a career at Mercy Health Home Care The Accounts Receivable Specialist is responsible for implementation and coordination of fiscal transactions in a timely and accurate manner. This includes claims processing, cash collection, claims resolution, resolving credit balances, EOM balancing and monthly statements. Responsible for pre claim review to assure billing compliance as required by company. Is accountable for complying with all policies, procedures and regulations related to billing all Medicare, Medicaid and other Third Party Payors. Mission/Core Values: It is expected that all of the duties and responsibilities of this position will be performed in a manner consistent with the Ministry’s Standards of Behavior (CARE; Compassion: seeks to understand, listen and explain; Advocate: is the voice for the vulnerable; Respect: demonstrates the highest regard for and welcomes all people; Excellence: commits to the highest standard of quality care, joyful service, and teamwork) and in a manner that reflects the core values of Mercy Health which are: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life and Service. All supervisors and above are expected to model the organizational mission and values through their daily actions, decision making and priority setting. All supervisors and above are expected to develop, implement and monitor short and long range plans to meet or surpass standards consistent with the overall strategic plan. ESSENTIAL FUNCTIONS (7-10 statements) % Time 50% Examines denied and underpaid claims to determine reason for discrepancies. Communicates directly with payers to follow up on outstanding claims, file appeals, resolve payment variances, and ensure timely reimbursement. Ability to identify with specific reason underpayments, denials, and cause of payment delay. Works with management to identify, trend, and address root causes of issues in the A/R. Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and taken appropriate action accordingly. Documents activity accurately including contact names, addresses, phone numbers, and other pertinent information. Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management. Needs to be a strong problem solver and critical thinker to resolve accounts. 20% Responsibilities include posting remittance advice to patient accounts, resolving any errors after posting payments, posting guarantor payments, reconciling all posted cash, and requesting refunds. 11% Submit claims electronically or by paper according to payor specifications and filing limits. 10% Performs pre billing audits to assure billing compliance as required by company. 5% Answers all incoming phone calls to the business line accepting payments, answering billing questions, assisting patients with financial assistance and providing service recovery as needed. 2% Process patients statements monthly per policy. 2% Reviews all credit balances and processes as required by Medicare, Medicaid and all Third Party Payors. 100% Must Equal 100%. The above is intended to describe the general content and functions of this job. It is not to be construed as an exhaustive list of all duties or responsibilities. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation. The job description is subject to continual revisions as needed for patient care. Due to the services and care provided by this institution, personnel may be requested to serve in related capacities as determined by their qualifications in a different unit, department, and campus, in an effort to not disrupt patient care and continue to provide a safe environment to our patients. All employees are expected to follow Mercy Health policies and procedures, maintain high standards of safe work performance, and maintain good attendance and punctuality. MINIMUM EDUCATION Required Minimum Education: Specialty/Major: Preferred Education: Required Minimum Education: High School Diploma or GED-Specialty/Major: Preferred Education: 2 Year/ Associate Degree Specialty Major: Accounting, Finance or related Combination of post-secondary education and experience will be considered in lieu of degree. Specialty/Major: Accounting, Finance or related LICENSURE/CERTIFICATIONS (must be non-expired/active unless otherwise stated): Required: Preferred: MINIMUM QUALIFICATIONS Minimum Years and Type of Experience: High School Diploma. One year experience in medical collections or professional billing required. Other Knowledge, Skills and Abilities Required: Must demonstrate basic computer knowledge, ability to use standard office equipment and basic MSOffice software. Problem solving skills related to account resolution. Adapt to changing procedures and growing environment. Other Knowledge, Skills and Abilities Preferred: 1-3 years of relevant experience in medical collections or professional billing preferred. Knowledge of claims review and analysis. This position requires the incumbent to demonstrate proficiency in clinical skills for patients in the following age categories (check all that differ from main job description): PHYSICAL REQUIREMENTS (select all that apply) PHYSICAL DEMANDS Please indicate the activity’s level of frequency that applies to this position using the following frequency scale: 1 = Not at all within shift (0%), 2 = Occasionally within shift (1-33%), 3 = Frequently within shift (34-66%), 4 = Continuously within shift (67-100%); ACTIVITY 1 2 3 4 ACTIVITY 1 2 3 4 ACTIVITY 1 2 3 4 Standing Climbing Crouching/ Squatting Walking Bending Crawling Sitting Twist at waist Kneeling Balancing Push/Pull with force < 50 lbs Push/Pull with force > 50 lbs Reaching above head Reaching above shoulder Lift/Carry Up to 50 lbs Lift/Carry >50 lbs<100 lbs Lift from floor level up Lift from waist level up Lift above shoulder Lift above head Driving MENTAL REQUIREMENTS (select all that apply) WORKING CONDITIONS (select all that apply) Mercy Health is an equal opportunity employer. Many of our opportunities reward* your hard work with: Comprehensive, affordable medical, dental and vision plans Prescription drug coverage Flexible spending accounts Life insurance w/AD&D Employer contributions to retirement savings plan when eligible Paid time off Educational Assistance And much more *Benefits offerings vary according to employment status Scheduled Weekly Hours: 40 Work Shift: Days (United States of America) Department: Administration - Youngstown Home Care/DME/Hospice All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employer, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com Mercy Health is part of Bon Secours Mercy Health, one of the top 20 health systems in the United States and part of the top performing quartile of Catholic health systems for lowest cost per case for patient care. Mercy Health is the largest health system in Ohio and among the top five employers in the state, with more than 33,500 employees serving communities throughout Ohio and in Kentucky. Mercy Health provided care for patients more than 6.8 million times in 2017. The system includes assets of $6.8 billion and nearly 500 care facilities including 23 hospitals and 26 post-acute care facilities including senior living communities, hospice programs and home health agencies. Its clinically integrated network of more than 2,700 health care providers coordinates more effective and efficient care for more than 350,000 patients, saving money for taxpayers through the Medicare Shared Savings Program. As part of Bon Secours Mercy Health, the ministry provides nearly $2 million per day in community benefit. For more information, visit www.mercy.com.