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Patient Financial Services Follow Up
Mercyhealth Wisconsin and IllinoisClaims Verifier at Mercyhealth following up on healthcare claims for payment. Evaluating reasons for denials and managing appeals during the claims process.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare billing processes, including claims verification, appeals drafting, and compliance with financial services policies. Proficient in utilizing technology and software applications to manage and resolve account balances effectively.
Highest-signal resume keywords
Healthcare Billing ExperienceClaims VerificationAppeals DraftingMicrosoft ExcelBusiness Writing Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims VerificationAppeals DraftingAccount ResolutionClaims ResearchPayer Follow-Up
Soft Skills
Communication SkillsProblem-Solving Skills
Tools & Technologies
Multiple Software ApplicationsComputer Systems
Industry Keywords
Payer ComplianceClaim Adjustment Reason CodesExplanations of BenefitsPatient Financial ServicesNo Authorization Denials
About the role
Key responsibilities & impact- Verifies claims are received by the payer and follows up to obtain payment via phone calls, portal or website use.
- Reviews claim adjustment reason codes or explanations of benefits received by the payer for appropriate follow-up.
- Evaluates next steps and takes action to call payer, follows up with a resubmission or dispute as required.
- Drafts an appeal or complete reconsideration forms according to payer requirements.
- Obtains and sends medical records during the appeals process when needed.
- Calls patients or payers directly to obtain needed information to resolve an account balance.
- Identifies trends with payor rejections or denials and escalates these trends to leads/supervisors.
- Uses computer systems/technology to locate claims information to resolve account balances.
- Maintains compliance with patient financial services policies and procedures.
- Researches accounts that are denied for No Authorization as a priority to appeal or escalate.
Requirements
What you’ll need- High school diploma or equivalent
- Microsoft Excel required
- Healthcare billing experience preferred
- Basic understanding of working in multiple software applications at the same time
- Basic business writing skills
Benefits
Comp & perks- Medical
- Dental
- Vision
- Life & Disability Insurance
- FSA/HSA Options
- Generous, accruing paid time off
- Paid Parental and caregiver leave
- Career advancement and educational opportunities
- Tuition and certification reimbursement
- Certification Reimbursement
- Well-being Programs
- Employee Discounts
- On-Demand Pay
- Financial Education
- Annual recognition/awards events
- Partner appreciation days
- Family entertainment/attractions discount
- Community service/improvement opportunities