Acute Claim Biller - UB04 & CMS-1500 (eClinicalworks)

Job Summary The Acute Claim Biller - UB04 & CMS-1500 (eClinicalWorks) position is responsible for day-to-day execution of complete business office services. This position is responsible for providing claims processing services to Critical Access Hospital (UB-04) and Rural Health Clinic (CMS-1500) facilities. This includes coordinating the day to day activities of a hospital's or clinic’s business office such as patient billing and collection, third-party payer relations, and/or preparation of insurance claims.

Essential Functions:

In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

• •Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry.
• •Recommends new processes and changes in current processes.
• •Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures
• •Implements appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts
• •Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third-party requirements
• •Responsible for consistently meeting production and quality assurance standards
• •Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
• •Updates job knowledge by participating in company offered education opportunities
• •Protects customer information by keeping all information confidential
• •Processes miscellaneous paperwork
• •Ability to work with high profile customers with difficult processes
• •May regularly be asked to help with team projects
• •Responsible for assisting manager in the management of employees which would include coaching, training and performing necessary disciplinary actions including following up on action plans for their employees.
• •Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
• •Ensures employee compliance with dress code, attendance and other company policies.
• •Processes miscellaneous paperwork and performs other administrative duties as assigned.

Minimum Requirements:

Education/Experience/Certification Requirements

• •At least 3-5 years Full-Cycle billing experience, to include BOTH Acute Hospital and Physician (Profee) claims
• •Experience with Claims AND Denial work queue's
• •Experience using eClinicalWorks E.M.R - REQUIRED
• •Familiar with Commercial, Workers Comp, and VA claims REQUIRED
• •Strong organizational, multi-tasking, and time-management skills.
• •Must be detail oriented and able to follow through on issues to resolution.
• •Must be able to act both independently and as a team member.
• •High School Diploma or equivalent combination of education and relevant experience needed.
• •Excellent critical thinking, organizational, and time management skills with a strong attention to detail, accuracy, and follow through