Revenue Cycle Reimbursement Analyst
Mercyhealth Wisconsin and Illinois
full-time
Posted on:
Location Type: Hybrid
Location: Janesville • Illinois • Wisconsin • United States
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Salary
💰 $21 - $32 per hour
About the role
- Interpret and understand coverage and benefit limitations by having a comprehensive understanding of benefits and state requirements for multiple markets.
- Identify trends and suggest and develop efficiencies in the revenue cycle through review and trending of payer contracts and reimbursement trends.
- Research and trends denials from payors.
- Reads through healthcare contracts and contract language and ensures proper contract workflows.
- Researches remittances and Explanation of Benefits (EOBs) for complete accurate payments or denials.
- Work with payers to understand specific reasons for variances and/or denials and measures to prevent future denials.
- Research payer policies and requirements and utilize knowledge to determine whether an appeal is required and to get claims overturned.
- Develop sound and well-supported appeal arguments, where an appeal is warranted.
- Submits corrected claims and appeals.
- Coordinates appeals with clinical or coding areas within the revenue cycle.
- Requests appropriate adjustments, when required.
- Provide training and guidance to team members on market specific issues by providing feedback to management on claims and provider issues, and updating client business rules.
- Partner with Reimbursements team to assist in completing all other tasks as necessary to ensure accurate and timely internal turnaround times.
Requirements
- Associate's degree in finance, business, or healthcare administration and 3 years' experience working in revenue cycle, denials management and contract management required.
- 5 years of experience in lieu of degree.
Benefits
- 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.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
revenue cycle managementdenials managementcontract managementclaims submissionappeal developmentpayer contract analysisremittance researchEOB analysisadjustment requestsworkflow coordination
Soft Skills
analytical skillsproblem-solvingcommunicationteam collaborationtraining and guidancefeedback provisionorganizational skillsattention to detailtrend identificationefficiency development
Certifications
Associate's degree in financeAssociate's degree in businessAssociate's degree in healthcare administration