Job Description
Overview Computes, classifies, records, and verifies numerical data for use in maintaining accounting records by performing the following duties.
Performs other duties as assigned.
Responsibilities Essential Duties and Responsibilities
•Process monthly premium billing for all groups and individuals
•Processing of premium payments including posting to accounts, documenting payments and tracking
•Reconciliation of self-administered large group accounts
•Reconciliation of premium payments against the relevant premium bill documenting differences for follow-up or for future reference with the group or individual members.
•Processing of monthly ACH withdrawals
•Customer service regarding premium billing including receiving and making calls to groups regarding accounts and issues related to premium billing from rating to past due amounts, regarding participation issues and documentation
•Management of collection processes from sending of collection letters to filing with collection agency
•Process claim payment runs by submitting file to third party administrator, balancing of check register and set up of payment withdrawals through the bank.
•Customer service for vendors/providers in regards to EOP'S and EOB'S.
•Reconciliation of claim refunds received and processed
•Review and research medical claims pended due to reimbursement issues
•Prepares reports for analysis of new marketplace members and payments to vendors.
•Maintain users in company credit card processing system.
•Actively participate in system analysis and process improvement efforts related to premium billing and medical reimbursement.
•Assist with audits by/from external reporting agencies as well as independent audits.
•Any and all duties and responsibilities as may be necessary.
•Overtime is required and may be necessary from time to time with little notice.
Education and Experience
Associates Degree in accounting or finance related field or two or more years of related experience preferred. A basic understanding of CPT codes, ICD-9 diagnosis codes and revenue codes is helpful. Prior knowledge of computer spreadsheet and word processing applications required.
Skills and Abilities
Must have excellent written and communication skills, quick-learner and problem-solver, strong PC and spreadsheet skills and able to follow detailed instructions, flexible working hours.
Special Physical Demands
Manual dexterity is needed to operate keyboard
Repetitive finger, wrist movement associated with use of keyboard Prolonged sitting
Benefits Mercyhealth offers a generous total rewards package to eligible employees including, but not limited to:
•Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.
•Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.
•Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance.
•Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.
•Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.
•Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning. Mercy Health System
Job Tags
Flexible hours, Shift work,