Mercy Health

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Insurance Verification Clerk*

Insurance Verification Clerk*

Requisition ID 
2017-746917
Category 
Support Services
Position Type 
Full Time
Shift(s) 
Days
Department 
Medical Supply Central Svcs
Location 
US-MO-Springfield

More information about this job

Overview

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We’re a Little Different

 

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.  

 

We don’t believe in jobs at Mercy, we believe in careers that match the unique gifts of unique individuals; careers that not only make the most of your skills and talents, but also your heart.

 

At Mercy, you’ll feel our supportive community every step of your day, especially the tough ones. We’re a team and love working that way. That team is expanding, and we currently have exceptional opportunities to help our communities grow.

 

Responsibilities and Qualifications

Responsible for representing the philosophy and mission statement of the St. John’s Health System and the sisters of Mercy to the Health System staff, customers and the community as well as upholding all applicable patient rights and responsibilities.

Maintains an on-going knowledge of and complies with St. John’s Health System and St. John’s Home Care policies and procedures.

Responsible for continuing compliance with federal and state regulations, other standards as appropriate, and Health System and St. John’s Home Care policy and procedure.

Responsible for promoting and establishing effective communication with all personnel, departments, referring office, corporate entities, system customers and the community.

Wears clothing and Health System badge consistent with dress code, and attends to personal hygiene to maintain a clean, well-groomed appearance. Observes universal precautions consistently.

Acquires and maintains current knowledge of documentation, authorization and billing requirements for Federal and State funded programs.

Evaluates all orders for equipment and supplies for complete information and determines whether information meets criteria for coverage.

Functions as education resource to the referring physician and to the patient to identify the criteria necessary for payer coverage of specific home medical equipment.

Verifies insurance coverage, coinsurance responsibility, and payer requirements.

Coordinates procurement of physician orders, exception and prior authorizations; initiates CMNs and tracks for timely return. Responsible for assuring appropriate, timely and complete physician orders and Certificate of Medical Necessity for all equipment/supplies and clinical service delivery.

Maintains database files to “hold” or “release” billing appropriate to status of signed orders/documentation.

Develops and maintains an on-going knowledge of billing, documentation, and reimbursement regulations/requirements of various funding sources.

Identifies and works to effectively resolve identified problems and opportunities for program improvement.

Demonstrates the ability to prioritize assignments based upon client and program needs and satisfaction.

Responsible for knowledge and compliance of regulatory standards as set by those agencies (i.e. JCAHO, OSHA, FDA Medicare, Medicaid, etc.).

Back up customer service personnel during busy times or low attendance as needed.

Maintains on-going knowledge of and complies with St. John’s Health System and St. John’s Home Care policies and procedures.

Work closely with Accounts Rreceivable staff to resolve billing issues.

Meets Health System attendance standards.

 

Qualifications:

 

Because you’re committed to excellence, you understand the importance of being properly prepared for your role at Mercy. That’s why you’ll bring to your role the right set of qualifications:

 

  • No education requirement
  • One year previous medical office experience

 

We’ll Support You at Work and Home

 

Our foundations are built on dignity and respect. Modern Healthcare Magazine named us as a “top 100 places to work.” We go out of our way to help people feel welcomed. We offer day-one comprehensive health, vision and dental coverage, PTO, and employer-matched retirement funds, even to part-time employees. We’re proud to provide tuition reimbursement to help you grow and learn new skills.

 

What Makes a Good Match for Mercy

 

Compassion and professionalism go hand-in-hand with us, along with exceptional quality care. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We’re also collaborative and are not afraid to do a little extra to deliver excellent care – that’s just part of our commitment. If that sounds like a fit for you as well, we encourage you to apply.

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