• Lead enterprise-wide reporting initiatives that drive strategic decision-making and business transformation. • Partner closely with executive leadership and cross-functional stakeholders to deliver actionable insights. • Establish reporting standards and support organizational performance objectives. • Translate complex data into meaningful business recommendations. • Influence business outcomes through data-driven insights.

• Prepare strategic pricing proposals for national, regional, and multinational new business tenders • Support new business development efforts, including building and editing financial pricing models for prospective clients • Support existing client retention and expansion efforts, including upholding pricing policies and procedures to ensure financial proposals are accurate, profitable, and designed in conjunction with overall company objectives • Provide financial review and profitability analysis for distribution to senior executives • Calculate and track sales quota and commission plan performance for sales team • Align across functional units to create winning pricing strategies and proposals • Develop creative and cost effective plans to meet client objectives

Role Description - 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 to determine what reasons for denials records are indicating for appropriate follow-up. - 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. - 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. - Obtains and sends medical records during the appeals process when needed to substantiate medical necessity. - Ability to review billing forms for both paper submissions and electronic submissions for accuracy. - Calls patients or payers directly without hesitation to obtain needed information to resolve an account balance when applicable. - 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. - Uses fax machine and other office equipment during the course of normal daily operations. - Reviews accounts based on patient or departmental inquiries and works with other Mercyhealth departments in a timely fashion if outstanding questions are not resolved and a claim is in jeopardy of not being paid. - 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. - 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. - Works billing functions when needed. - Escalates high dollar accounts for a second level appeal if needed. - Reports equipment malfunctions and supply needs, as necessary. - 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. - Applies creative problem-solving skills in order to overcome obstacles and resolve errors for claim adjudication. - Coordinates with management and external departments to resolve unresolved accounts and potentially create process redesign initiatives for long term root cause resolution. - Completes special projects as assigned. - Maintains a comprehensive awareness of all insurance company updates including Federal and State guidelines. - Meets productivity goals as assigned by the Revenue Cycle Director. Qualifications - High 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. Requirements - Pay Range: $17.92 - $26.88 Benefits - 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

Role Description - 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 to determine reasons for denials for appropriate follow-up. - 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. - Drafts an appeal or complete reconsideration forms when applicable based on payer requirements in a logical format related to the open denial of payment. - Obtains and sends medical records during the appeals process when needed to substantiate medical necessity. - Ability to review billing forms for both paper submissions and electronic submissions for accuracy. - Calls patients or payers directly to obtain needed information to resolve an account balance when applicable. - 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. - Uses fax machine and other office equipment during normal daily operations. - Reviews accounts based on patient or departmental inquiries and follows up with other Mercyhealth departments in a timely fashion if outstanding questions are not resolved. - 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. - Researches accounts denied for No Authorization as a priority in the attempt to appeal or escalate to Precertification department if a retro authorization may be needed. - Works billing functions when needed. - Escalates high dollar accounts for a second level appeal if needed. - Reports equipment malfunctions and supply needs, as necessary. - 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. - Applies creative problem-solving skills to overcome obstacles and resolve errors for claim adjudication. - Coordinates with management and external departments to resolve unresolved accounts and potentially create process redesign initiatives for long-term root cause resolution. - Completes special projects as assigned. - Maintains a comprehensive awareness of all insurance company updates including Federal and State guidelines. - Meets productivity goals as assigned by the Revenue Cycle Director. Qualifications - High 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. Requirements - Pay Range: $17.92 - $26.88 Benefits - 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