Reimbursement Specialist HME-Full time-Dubuque

Description

At MercyOne, health care is more than just a doctor’s visit or a place to go when you’re in need of medical attention. Our Mission is based on improving the health of our communities – that means not only when you are sick but keeping you well. MercyOne Dubuque is the leading hospital in the tri-states, offering the only comprehensive cardiology center and Level II regional neonatal intensive care unit in the area as well as the newly constructed MercyOne Dubuque Cancer Center. Other services include a trauma center, a CARF-accredited inpatient rehabilitation unit, orthopedics, retail pharmacies, palliative care and a wide range of outpatient and community services. MercyOne operates two hospital-based skilled nursing units and a 40-bed nursing home. In recognition of the strength of its nursing service and the overall quality of patient care, MercyOne Dubuque has been designated a Magnet hospital four consecutive times – the nation’s most prestigious award for nursing excellence.

Employment Type

Full time

Shift

Day Shift

As a Reimbursement Specialist at MercyOne, you will be responsible for:

• Reviewing and making necessary corrections prior to billing
• Preparing and submitting the hardcopy claims generated from Brightree
• Responding to and resolving all requests for information concerning the receivables
• Reviewing and addressing partial payments and denials
• Reviewing and resolving outstanding receivables not paid in a timely manner
• Responds to accounts receivable inquiries/issues and performs assigned tasks and research in a timely, professional manner
• Customers include clients, families, third party payers, physicians, referral sources, community, home medical equipment and hospital staff

General Requirments

• Performs all related accounts receivable tasks utilizing appropriate policies, guidelines, and standards
• Ensures compliance with regulatory bodies such as CMS, The Joint Commission, and others
• Ensures charges are valid and meet the payers’ coverage criteria and documentation requirements prior to generating a claim/invoice
• Prepares and submits all paper claims in a timely manner
• Performs follow-up and resolution of all charges rejected at the front-end edits for charges submitted electronically

Schedule

• List schedule requirements, hours, weekend and holiday requirements

Education

• High school graduate or equivalent
• Preferrable: 1-2 years’ experience in billing and/or accounts receivable work
• Preferrable: Background in homecare or another related medical/health field
• Preferrable: Background/experience in medical equipment receivables including HME reimbursement/coverage and regulatory standards
• Preferrable: Medical terminology background

Benefits

Competitive compensation with a full benefits package and opportunity for growth throughout the system!

Visit MercyOne Careers to learn more about the benefits, culture, and career development opportunities available to you at MercyOne Health System

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Location

Dubuque, Iowa (IA)

About the location

The Dubuque Community School District is highly regarded, and the city offers private schools plus colleges like Loras College and Clarke University. Families enjoy cultural attractions such as the National Mississippi River Museum, arts festivals and an abundance of parks and trails. As the region’s leading hospital, MercyOne Dubuque Medical Center offers the only Level II NICU and the most comprehensive cardiology center in the tri‑state area. It holds Magnet designation (fifth consecutive cycle), CMS 5-star quality rating and national recognition including Fortune/IBM Watson’s 100 Top Hospitals. It’s a Wellmark Blue Distinction Center+ for maternity and earns American Heart Association awards — Stroke Gold Plus, Mission: Lifeline NSTEMI and STEMI Gold. It recently celebrated 100 years of American Heart Association membership.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.