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Insurance Billing Representative, Patient Accounts

February 19, 2026

Overview <ul><li>Insurance Billing Rep, Patient Accounts Follow Up, Remote, 80 Hrs / wks</li><li>Location: Remote - Mercyhealth does not currently support remote workers with residency in the following states: CA, OH, OR, PA, NJ, NY.</li><li>Flexible work schedule opportunity avaliable. </li></ul> Responsible for ensuring claims are resolved with third party payers in a reasonable time frame as defined by Revenue Cycle metrics. This includes working claims that fail payer rejection edits in order to resolve errors and submit corrected claims. Assesses errors and quickly and effectively locates information to correct them and follow-up on claims for resolution. Works with other areas in the Revenue Cycle to obtain information necessary to correct errors or supply additional information as necessary for claim adjudication. Remains up-to-date on regulatory requirements through informal and formal updates, including self-study of payer bulletins and guidelines. Performs other duties as assigned. Responsibilities ESSENTIAL DUTIES AND RESPONSIBILITIES<ul><li>Verifies claims are received by the payer and follows up to obtain payment via phone calls, portal or website use.</li><li>Reviews claim adjustment reason codes or explanations of benefits received by the payer to determine what reasons for denials records are indicating for appropriate follow-up.</li><li>After denial review, evaluates next steps and takes action to call payer, follows up with a resubmission or dispute/appeal/reconsideration as required by payer, or works internally to receive payment on account.</li><li>Drafts an appeal or complete reconsideration forms when applicable based on payer requirements in a format that is logical and relates to the open denial of payment.</li><li>Obtains and sends medical records during the appeals process when needed to substantiate medical necessity.</li><li>Ability to review billing forms for both paper submissions and electronic submissions for accuracy.</li><li>Calls patients or payers directly without hesitation to obtain needed information to resolve an account balance when applicable.</li><li>Identify trends with payor rejections or denials and escalates these trends to leads/supervisors.</li><li>Uses computer systems/technology to locate claims information to resolve account balances.</li><li>Maintains compliance with patient financial services policies and procedures.</li><li>Uses fax machine and other office equipment during the course of normal daily operations.</li><li>Reviews accounts based on patient or departmental inquiries. Also, works and follows up with other Mercyhealth departments in a timely fashion if outstanding questions are not resolved and a claim is in jeopardy of not being paid.</li><li> Interacts with other Patient Financial staff members to provide pertinent information, which may include training and document sharing, and to ask for guidance to resolve knowledge base deficiencies.</li><li>Researches accounts at a higher level that are denied for No Authorization as a priority in the attempt to appeal or escalate to Precertification department if a retro authorization may be needed.</li><li>Works billing functions when needed.</li><li>Escalates high dollar accounts for a second level appeal if needed.</li><li>Reports equipment malfunctions and supply needs, as necessary.</li><li>Accesses available resources, such as the patient accounting system, biller files, other areas in the Revenue Cycle, or payer databases, to locate missing or incorrect information. Apply creative problem-solving skills in order to overcome obstacles and resolve errors for claim adjudication.</li><li>Coordinates with management and external departments to resolve unresolved accounts and potentially create process redesign initiatives for long term root cause resolution.</li><li>Completes special projects as assigned.</li><li>Maintains a comprehensive awareness of all insurance company updates including Federal and State guidelines.</li><li>Meets productivity goals as assigned by the Revenue Cycle Director.</li></ul> EDUCATION AND EXPERIENCEHigh school diploma or equivalent. Microsoft Excel required and healthcare billing experience preferred. Undertakes self-development activities. Basic understanding of working in multiple software applications at the same time. Culture of Excellence Behavior Expectations <iframe src="//www.youtube.com/embed/t599IHFQh7s" width="560" height="314" allowfullscreen="allowfullscreen"></iframe> Benefits Mercyhealth offers a generous total rewards package to eligible employees including, but not limited to: · 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.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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