Mercyhealth

The representative is responsible for ensuring claims are resolved with third-party payers in a timely manner by working rejections, correcting errors, and submitting corrected claims. This involves reviewing Explanation of Benefits, drafting appeals or reconsiderations, and obtaining necessary medical records for claim adjudication.

The Revenue Cycle Reimbursement Analyst is responsible for reviewing payor contracts and variances, analyzing accounts receivable, and working with insurance carriers to maximize reimbursement. This includes researching denials, developing appeal arguments, and coordinating with clinical or coding areas.