Mosaic Life Care

Financial Planning and Analysis

• Assist with patient complaint escalation and resolve billing disputes
• Maintain department orientation pathways, training material, and compliance audits
• Advise patients and family members of financial obligations through multiple communication channels
• Verify patient eligibility and benefits and estimate financial obligations
• Obtain payment in full or secure payment arrangements for hospital and ambulatory health services
• Serve as a resource to financial clearance, benefit advisory, advocacy, care management, and hospital staff for billing and collections needs
• Identify financial assistance programs and connect patients and families with Enterprise Financial Counseling
• Educate patients and families about financial assistance applications
• Input data into electronic databases and complete daily reports accurately and on time
• Coordinate with third-party vendors, Care Management, county health officials, and D.H.S. workers
• Attend state and local hearings as needed
• Support the Patient Financial Services Call Center and resolve patient inquiries about financial counseling and collection policies
• Maintain current knowledge of department standards and comply with state and federal regulations
• Perform other duties as assigned

Lead Patient Financial Clearance Representative

Medical Billing and Coding

• Code procedures and diagnoses using ICD-10-CM and CPT classification systems in accordance with official coding guidelines, CMS guidelines, payer rules and policies, and Mosaic compliance standards
• Participate in online educational sessions, workshops, conferences, and/or in-services and maintain participation records
• Communicate with providers and query them to ensure documentation specificity
• Work with Patient Financial Services, Revenue Integrity, or other departments to verify and modify charges and coding
• Ensure accuracy of State HIDI data and other claims by responding to edits
• Perform specialty care claims rejections or denials
• Assist in training newly hired coders
• Perform other assigned duties
• Code outpatient services including emergency room, injection and infusion, non-complex outpatient surgeries, and obstetric observation
• Code multiple specialties or non-complex surgical specialties

Clinic/Outpatient Coder II

Customer Support

• Take inbound calls from patients, attorneys, insurance companies and vendors
• Make outbound follow-up calls and calls to assist in resolution of accounts
• Respond to written inquiries from patients, attorneys, insurance companies and vendors
• Assist with account resolution by discussing payment and financial assistance options
• Process and input patient data and fulfill document requests
• Maintain performance and quality standards, including aiding in prevention of abandoned calls
• Ensure compliance with confidential data, including HIPAA compliance
• De-escalate patient complaints related to current or past-due services and/or balances
• Research the patient accounting system to assist patients with questions about previous visits
• Work under the direction of the Customer Service Manager and escalate issues to team leads or functional caregivers as appropriate
• Perform other duties as assigned

Lead Patient Financial Clearance Representative

Clinic/Outpatient Coder II

Patient Financial Clearance Customer Service Representative