Mercy Medical Center Clinton SO_Posting Representative_T1072 in Boise, Idaho
IN308_69603 Uro - Papfs West Usa Admin
Expected Weekly Hours:
The Posting Representative performs cash transaction and payment posting; and balances, records and prepares bank deposits in a timely, accurate manner. Uses HealthQuest to calculate the patient and insurance balances when posting payments and denials. Posts insurance denials with associated reasons for insurance remittance advices for follow up by the disputed claims staffs. Additionally, the incumbent correlates, edits and ensures that all data is received and processed correctly
Job Description Details:
The Posting Representative performs cash transaction and payment posting; and balances, records and prepares bank deposits in a timely, accurate manner. Uses HealthQuest to calculate the patient and insurance balances when posting payments and denials. Posts insurance denials with associated reasons for insurance remittance advices for follow up by the disputed claims staffs. Additionally, the incumbent correlates, edits and ensures that all data is received and processed correctly.
Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
Posts payments from patients, guarantors and 3rd party payers that are received via various Ministry Organization departments, in the mail or the lockbox via electronic and manual transactions:
Processes credit/debit card transactions;
Processes payroll deduction payments;
Processes denials, entering the appropriate transaction code in order to distribute the denial to the appropriate Patient Accounting or Disputed Claims Management team;
Follows-up on insufficient fund checks/debit transactions;
Balances and reconciles all electronic vouchers (Medicare, Medicaid, Blue Cross, etc.), files, checks and EOBs:
Researches and resolves unapplied cash and misapplied payment requests;
Verifies electronic fund transfers;
Contacts payers for missing EOBs and ERAs.
Communicates with physicians and their office staff, Patient Access, Medical Records/Health Information Management, Utilization Review/Case Management, Managed Care, Ancillary and Nursing staff, as required to clarify billing discrepancies, and obtain demographic, clinical, financial and insurance information.
Prepares special reports as directed by the Manager to document billing and follow-up services (e.g., Receipt, daily deposit and daily reconciliation logs, etc.).
May serve as relief support, if the work schedule or workload demands assistance to departmental personnel. May also be chosen to serve as a resource to train new employees. Cross- training in various functions is expected to assist in the smooth delivery of departmental services.
Other duties as needed and assigned by the manager.
Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
High school diploma or an equivalent combination of education and experience. Associate degree in accounting or business administration highly desired. Data entry skills (50-60 keystrokes per minutes). Past work experience of at least one year within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing payment posting, medical claims processing, and/or other similar task is required. Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is highly desirable. Working knowledge of medical terminology, anatomy and physiology, medical record coding (ICD-9, CPT, HCPCS), and basic computer skills are highly desirable.
The incumbent must possess excellent communication (verbal and writing) and organizational abilities. Interpersonal skills are necessary in dealing with internal and external customers. Accuracy, attentiveness to detail and time management skills are required.
To successfully accomplish the essential job functions of this position, the incumbent will be required to work independently, read, write, and operate keyboard and telephone effectively.
Must be comfortable operating in a collaborative, shared leadership environment.
Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
Must be able to set and organize own work priorities, and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. Excellent problem solving skills are essential.
This position requires the ability to comprehend and retain information that can be applied to work procedures to achieve appropriate service delivery.
The greatest challenge in this position is to ensure that payment posting activities are performed promptly and in an accurate manner to assist in order to reduce potential financial loss to the patient and the Ministry Organization. The incumbent must have a thorough knowledge of various insurance documentation requirements, the patient accounting system, and various data entry codes to ensure proper service documentation and billing of the patient's account.
Position operates in an office environment. Work area is well-lit, temperature controlled and free from hazards. The incumbent is subject to eyestrain due to the many hours spent looking at a CRT screen. The noise level is low to moderate.
Completion of regulatory/mandatory certifications and skills validation competencies preferred.
Must possess the ability to comply with Trinity Health policies and procedures.
Trinity Health's Commitment to Diversity and Inclusion
Trinity Health employs more than 120,000 colleagues at dozens of hospitals and hundreds of health centers in 21 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.
Trinity Health offers rewarding careers in a community environment with all the advantages of working at one of the nation's largest health systems. We provide high-quality, people-centered care in 22 states through our network of hospitals, facilities, community-based services, and continuing care locations - including home care, hospice, Program of All Inclusive Care for the Elderly (PACE), and senior living facilities. If you are looking for a rewarding clinical or administrative position, you'll find exceptional career possibilities, opportunities for advancement and a job with meaning at Trinity Health.
Trinity Health employs more than 131,000 colleagues across 22 states. We honor and embrace a diverse representation of people, ideas and backgrounds. Our dedication to diversity is evident in our commitment to training, education, recruitment, retention and development, as well as community partnerships and supplier diversity.
Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences and health practices of the communities we serve and to apply that knowledge to produce positive outcomes. We recognize that each of us has a different way of thinking and perceiving our world, and that our differences not only serve to unite us, but also lead to innovative solutions.