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$15,000 Sign-on BonusUp to $10,000 Education Assistance Available  Your time at work should be fulfilling. Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities. Imagine your career at Catholic Health Initiatives!  Job Responsibilities As a Registered Nurse, you will be responsible for delivering the highest quality patient care according to the specific orders of each patient’s individual physician. This will involve, utilizing your knowledge and skills to educate patients and their families on prevention and healthy habits. Additional responsibilities for this health care role include: - Monitoring patients’ conditions and assessing their needs - Collaborating with physicians and nurses to devise individualized care plans for patients - Administering patients’ medications and providing treatments according to physicians’ orders - Fostering a supportive and compassionate environment to care for patients and their families

Your time at work should be fulfilling. Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities. Imagine your career at Catholic Health Initiatives!   **Eligible for New Hire $9K Sign-on Bonus**   Job Responsibilities As a Registered Nurse, you will be responsible for delivering the highest quality patient care according to the specific orders of each patient’s individual physician. This will involve, utilizing your knowledge and skills to educate patients and their families on prevention and healthy habits. Additional responsibilities for this health care role include: - Monitoring patients’ conditions and assessing their needs - Collaborating with physicians and nurses to devise individualized care plans for patients - Administering patients’ medications and providing treatments according to physicians’ orders - Fostering a supportive and compassionate environment to care for patients and their families

This job is responsible for providing nursing care and support to patients under the direction of a Registered Nurse (RN) in a defined care team and in accordance with assigned tasks and permitted by the Nursing Skills Checklist, with the exception of administering medication.  An incumbent assumes responsibility for their own actions taking into consideration clinical experience/education preparation, while being an active student in an accredited nursing program.  A school-signed copy of the incumbent’s Nursing Skills Checklist is kept on file and updated regularly.    Tasks are assigned by nursing staff in clear, detailed and specific instructions.  Employees work as instructed and seek guidance on matters not specifically covered in the original instructions.  Work is reviewed through progress checks for accuracy, adequacy and adherence to standards, instructions and established procedures.     - Provides patient personal care/hygiene and physical comfort within assigned tasks, including feeding, bathing, shaving, changing clothes, bed making, ambulation, lifting, turning, moving, transferring, enemas, skin care and bowel/bladder elimination. Provides such additional care as required to meet the personal primary needs and comfort of assigned patient based on skill, ability, and patient acuity.  Prepares patient, equipment and supplies for specific procedures/examinations.  - Performs, monitors, reports and documents all clinical activities within assigned tasks. Observes and reports changes in patient condition to the RN. - Assists nursing staff in the admission, discharge and transfer of patient by performing activities such as inventory/storing patient belongings, providing patient with relevant personal care/comfort items, orienting patient/family and transporting patient to room or other location using wheelchairs, stretchers or patient bed. - Provides patient information to nursing staff for inclusion in the interdisciplinary plan of care; documents relevant patient data in accordance with work unit standards. - Maintains a neat and organized work environment. Orders, stocks and replenishes supplies and equipment as necessary, identifies and reports problems with supplies or equipment; enters equipment repair request in system, tags equipment and removes from service.  - Participates in quality assurance/improvement initiatives and activities. Participates in growth opportunities.   Actively participates in ongoing education and orientation to the role of an RN, remaining within scope at all times.

- Provides teaching, supervision and evaluation of student learning experiences. - Provides individual advisement and guidance for intellectual and professional development of students. - Collaborates with other faculty, preceptors, field faculty, and clinical agencies to provide optimum learning opportunities for students. - Develops, implements and revises learning activities in a limited area. - Performs miscellaneous duties as assigned.

You’d look great in purple! Join our team in Des Moines where we help build future healthcare professionals. We not only offer students an exceptional education, but we also offer employees a challenging and rewarding work environment. Our core values of knowledge, reverence, integrity, compassion and excellence are at the foundation of how we work and what we do. We are committed to providing the best environment for students to learn and employees to work.   - Teaches and supervises students learning advanced life and pediatric life support skills. - Evaluates student's skills learned. - Ensures classroom is equipped with appropriate supplies and teaching tools.  

- Competent in effective delivery of practical knowledge in community health care in a variety of settings – classroom, work-site, telecommunication/distance learning. - Teaches in an interactive manner - Implements adult learning strategies. - Displays initiative and adherence to Mercy’s core values in recruiting, organizing, conducting and record keeping. - Communicates well with a variety of community/client populations. - Knowledge of education and industry/safety standards.

- Competent in effective delivery of practical knowledge in community health care in a variety of settings – classroom, work-site, telecommunication/distance learning. - Teaches in an interactive manner - Implements adult learning strategies. - Displays initiative and adherence to Mercy’s core values in recruiting, organizing, conducting and record keeping. - Communicates well with a variety of community/client populations. - Knowledge of education and industry/safety standards.

Under general supervision, the Insurance Follow-up Rep is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Memorial Health Partners Foundation (MHPF)  in accordance with established standards, guidelines and requirements.  An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently.  Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues.  In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution.                                                         Essential Key Job Responsibilities Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers. - Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. - Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmits claims with necessary information when requested through paper or electronic methods. - Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. - Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. - Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. - Assists with unusual, complex or escalated issues as necessary. - Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. - Accurately documents patient accounts of all actions taken in billing system. Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation.  - Uses critical thinking skills and payer knowledge to recommend system edits to reduce denials and result in prompt and accurate payment. - Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. - Communicates with supervisor and staff regarding insurance carrier contractual and regulatory requirements that impact payment and denials. Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. - Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures. Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. - Understands detailed billing requirements, denial reason codes, and insurance follow-up practices. - Understands government and commercial insurance reimbursement terms, contract language, and appropriate reimbursement amounts. Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.

Under general supervision, the Insurance Follow-up Rep is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Memorial Health Partners Foundation (MHPF)  in accordance with established standards, guidelines and requirements.  An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently.  Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues.  In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution.                                                         Essential Key Job Responsibilities Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers. - Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. - Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmits claims with necessary information when requested through paper or electronic methods. - Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. - Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. - Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. - Assists with unusual, complex or escalated issues as necessary. - Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. - Accurately documents patient accounts of all actions taken in billing system. Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation.  - Uses critical thinking skills and payer knowledge to recommend system edits to reduce denials and result in prompt and accurate payment. - Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. - Communicates with supervisor and staff regarding insurance carrier contractual and regulatory requirements that impact payment and denials. Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. - Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures. Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. - Understands detailed billing requirements, denial reason codes, and insurance follow-up practices. - Understands government and commercial insurance reimbursement terms, contract language, and appropriate reimbursement amounts. Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.

Under general supervision, the Insurance Follow-up Rep is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Memorial Health Partners Foundation (MHPF)  in accordance with established standards, guidelines and requirements.  An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently.  Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues.  In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution.                                                         Essential Key Job Responsibilities Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers. - Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. - Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmits claims with necessary information when requested through paper or electronic methods. - Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. - Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. - Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. - Assists with unusual, complex or escalated issues as necessary. - Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. - Accurately documents patient accounts of all actions taken in billing system. Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation.  - Uses critical thinking skills and payer knowledge to recommend system edits to reduce denials and result in prompt and accurate payment. - Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. - Communicates with supervisor and staff regarding insurance carrier contractual and regulatory requirements that impact payment and denials. Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. - Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures. Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. - Understands detailed billing requirements, denial reason codes, and insurance follow-up practices. - Understands government and commercial insurance reimbursement terms, contract language, and appropriate reimbursement amounts. Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.

Under general supervision, the Insurance Follow-up Rep is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Memorial Health Partners Foundation (MHPF) in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues. In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution.                                                       Essential Key Job Responsibilities Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers. - Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. - Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmits claims with necessary information when requested through paper or electronic methods.   - Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. - Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. - Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. - Assists with unusual, complex or escalated issues as necessary. - Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. - Accurately documents patient accounts of all actions taken in billing system. - Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation. - Uses critical thinking skills and payer knowledge to recommend system edits to reduce denials and result in prompt and accurate payment. - Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. - Communicates with supervisor and staff regarding insurance carrier contractual and regulatory requirements that impact payment and denials. - Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. - Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures. - Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. - Understands detailed billing requirements, denial reason codes, and insurance follow-up practices. - Understands government and commercial insurance reimbursement terms, contract language, and appropriate reimbursement amounts. - Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.

Under general supervision, the Insurance Follow-up Rep is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Memorial Health Partners Foundation (MHPF) in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues. In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution.                                                       Essential Key Job Responsibilities Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers. - Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. - Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmits claims with necessary information when requested through paper or electronic methods.   - Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. - Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. - Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. - Assists with unusual, complex or escalated issues as necessary. - Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. - Accurately documents patient accounts of all actions taken in billing system. - Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation. - Uses critical thinking skills and payer knowledge to recommend system edits to reduce denials and result in prompt and accurate payment. - Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. - Communicates with supervisor and staff regarding insurance carrier contractual and regulatory requirements that impact payment and denials. - Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. - Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures. - Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. - Understands detailed billing requirements, denial reason codes, and insurance follow-up practices. - Understands government and commercial insurance reimbursement terms, contract language, and appropriate reimbursement amounts.  - Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.

Mountain Management   Under general supervision, the Insurance Follow-up Rep is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Memorial Health Partners Foundation (MHPF) in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues. In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution.                                                       Essential Key Job Responsibilities Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers. - Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. - Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmits claims with necessary information when requested through paper or electronic methods.   - Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. - Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. - Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. - Assists with unusual, complex or escalated issues as necessary. - Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. - Accurately documents patient accounts of all actions taken in billing system. - Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation. - Uses critical thinking skills and payer knowledge to recommend system edits to reduce denials and result in prompt and accurate payment. - Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. - Communicates with supervisor and staff regarding insurance carrier contractual and regulatory requirements that impact payment and denials. - Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. - Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures. - Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. - Understands detailed billing requirements, denial reason codes, and insurance follow-up practices. - Understands government and commercial insurance reimbursement terms, contract language, and appropriate reimbursement amounts. - Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.

Under general supervision, the Insurance Follow-up Rep is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Memorial Health Partners Foundation (MHPF) in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues. In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution.                                                         Essential Key Job Responsibilities Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers. - Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. - Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmits claims with necessary information when requested through paper or electronic methods.   - Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. - Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. - Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. - Assists with unusual, complex or escalated issues as necessary. - Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. - Accurately documents patient accounts of all actions taken in billing system. - Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation. - Uses critical thinking skills and payer knowledge to recommend system edits to reduce denials and result in prompt and accurate payment. - Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding. - Communicates with supervisor and staff regarding insurance carrier contractual and regulatory requirements that impact payment and denials. - Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. - Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures. - Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. - Understands detailed billing requirements, denial reason codes, and insurance follow-up practices. - Understands government and commercial insurance reimbursement terms, contract language, and appropriate reimbursement amounts. - Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.

JOB SUMMARY / PURPOSE This job is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and non-coding denials in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. ESSENTIAL KEY JOB RESPONSIBILITIES Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is receive. Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. Resubmits claims with necessary information when requested through paper or electronic methods. Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. Assists with unusual, complex or escalated issues as necessary. Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. Accurately documents patient accounts of all actions taken in billing system. Other duties as assigned by leader and organization.  

JOB SUMMARY / PURPOSE This job is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and non-coding denials in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. ESSENTIAL KEY JOB RESPONSIBILITIES Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is receive. Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. Resubmits claims with necessary information when requested through paper or electronic methods. Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. Assists with unusual, complex or escalated issues as necessary. Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. Accurately documents patient accounts of all actions taken in billing system. Other duties as assigned by leader and organization.  

JOB SUMMARY / PURPOSE This job is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and non-coding denials in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. ESSENTIAL KEY JOB RESPONSIBILITIES 1. Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is receive. 2. Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. 3. Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. 4. Resubmits claims with necessary information when requested through paper or electronic methods. 5. Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. 6. Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. 7. Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. 8. Assists with unusual, complex or escalated issues as necessary. 9. Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. 10. Accurately documents patient accounts of all actions taken in billing system. 11. Other duties as assigned by leader and organization.

JOB SUMMARY / PURPOSE This job is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and non-coding denials in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. ESSENTIAL KEY JOB RESPONSIBILITIES 1. Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is receive. 2. Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. 3. Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. 4. Resubmits claims with necessary information when requested through paper or electronic methods. 5. Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. 6. Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. 7. Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. 8. Assists with unusual, complex or escalated issues as necessary. 9. Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. 10. Accurately documents patient accounts of all actions taken in billing system. 11. Other duties as assigned by leader and organization.   

Job Summary:   Responsible for follow up of insurance to include: claims submitted, appeal processes and inquiries; monthly accounts receivable reports to ensure timely and maximum reimbursement from assigned carriers.   Essential Responsibilities: - Field patient and insurance calls regarding patient account receivables. - Audit patient accounts for accuracy regarding charges, payments, demographics, insurance information and filing to ensure contractual agreements are being met. - Request adjustments, write-off, payment, refunds/recoups, and transfers when appropriate. - Work insurance aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper and timely payment while maintaining A/R aging per company guidelines to maximize reimbursement. - Submit patietn claims, paper and electronic, after corrections have been made or when rebilling is needed.  Create appeal letters to submit to insurance carrier for timely payments. - Review and reply (as needed) to all insurance correspondence, including assigned carrier newsletters and guidelines as well as maintain a working knowlege of assigned carrier website. - Maintain current knowledge of insurance guidelines through newsletters and websites. - Assist with demographics/charge entry and capture of all hospital charges. - Work in all areas of the department during peak times, vacations, illnesses, etc.

Franciscan Medical Group is currently looking for a full-time Insurance Services Rep for the Franciscan Regional Billing Office in Tacoma. 5 days a week with flexible start times and no weekends or major holidays required.   Job Summary: This job is responsible for addressing, resolving and resubmitting outstanding insurance balances and routine denials that typically involve researching authorization and/or insurance eligibility in accordance with established standards, guidelines and regulatory requirements.  An incumbent works with both commercial and government health insurance payers to resolve payment issues on accounts through investigation and evaluation of patient account information, medical records, claims, Explanation of Benefits (EOB’s), reimbursement regulations and communication with third party payers.  Work involves removing barriers to processing claims by calling the payer, working on-line systems when appropriate, rebilling insurance via fax, electronic or hard copy, transferring payments or adjusting accounts per FMG procedures for writing off balances and applying adjustments.  Work also involves significant attention to detail in reviewing insurance remittance documentation, researching routine denial reasons and gaining experience in resolving issues through the appeal process.   An incumbent gains experience in working with a wide variety of CPT codes associated with multiple specialties as well as broader knowledge of denial/reason codes and the ability to apply proactive critical thinking and troubleshooting skills to handle denials and resolution of issues that potentially impact revenue and customer satisfaction.  Work requires some knowledge of insurance follow-up processes for government and non-government payers, insurance authorization/eligibility processes and privacy/confidentiality practices, as well as knowledge of medical terminology and insurance payer requirements.  An incumbent follows proper channels of communication in handling routine problems and recognizing issues to be escalated in accordance with established procedures.  Strong customer service skills and the ability to produce work with a high degree of accuracy/timeliness while meeting productivity standards are also required.   Essential Duties: - Researches and resolves, within scope of position, rejected, incorrectly paid and/or denied claims within the established time frame; retrieves account data and references available resources to identify reasons for payment discrepancies and to quickly resolve outstanding claims in order to maximize appropriate revenue. - Accesses work queue to review claim/account status and to determine next steps/specific tasks to assure that accounts are properly reimbursed and to resolve payment issues. - Understands and interprets insurance EOBs, knowing when and how to assure that maximum payment has been received; gains experience in accurately deciphering denial reasons and in planning follow-up steps. - Contacts insurance companies, payers and/or other stakeholders to gather all necessary information; resolves issues (within scope of position) and facilitates/expedites prompt payment of claims; reopens claims as necessary to facilitate maximum reimbursement from insurance companies. - Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. - Resubmits claims (in hardcopy or electronic format) as requested to include all appropriate information. - Enters appropriate corrections in the practice management system to assure appropriate reimbursement is received for all FMG providers. - Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. - Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides. - Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc. - Documents all activities and findings in accordance with established policies and procedures; assures the integrity of all account documentation; maintains confidentiality of medical records. - Accurately documents patient accounts of all actions taken in billing system. - Documents clear and concise notes within Epic according to established standards to facilitate resolution of outstanding claims/issues and assure that other staff are able to understand the claim history. - Meets quality assurance and productivity standards for timely and accurate denial resolution in accordance with organizational policies and procedures. - Gains and maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. - Follows all department policies and procedures, desk level procedures, guidance documents, or other work tools designed to ensure accuracy, especially those requiring use of appropriate payment or adjustment codes. - Gains understanding of detailed billing requirements, denial reason codes, and insurance follow-up practices; gains advanced understanding of government and commercial insurance reimbursement terms, payment policies and appropriate reimbursement amounts. - Establishes and maintains professional and effective relationships with peers and other stakeholders. - Works collaboratively with payers and revenue cycle staff to explain denial or underpayment issues. - Establishes and maintains a professional relationship with clinics and FMG staff in order to research and/or resolve issues. - Performs related duties as required.