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Insurance & Govt Reimb Specialist,CBO, FT; M-F ,8:00am-5:00pm (9631)

Children's Hospital & Medical Center - Omaha Omaha, NE
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Job Description

When you work at Children’s, you’re part of a treasured place of healing in the Omaha community—and beyond. Join our team of highly engaged, caring professionals who believe deeply in the organization’s mission—to improve the life of every child. We support equity, diversity and inclusion, and as you apply your skills and expertise to helping children, you too will have opportunities to grow your career. In 2021, we’ll open the new Hubbard Center for Children, tripling our capacity to serve children.

When children are your everything, anything can be…

Children's is searching for a Insurance and Government Reimbursement Spec., Central Billing Office to collects outstanding insurance and government payor accounts and unpaid balances via telephone, email, and mail. Verifies the accuracy of all insurance and government payor payments, rebills underpayments, appeals denials and turns them into payments, and ensures accurate payor and government reimbursement on all claims.

Essential Functions/Competencies

% of Time

 

45%

  1. Follows up on outstanding insurance and government payor claims and charges in follow-up work queues and on various reports by contacting insurance or government carriers and patients for status including processing correspondence.

20%

  1. Rebills underpayments, appeals denials and turns them into payments, ensures accurate reimbursement from insurance and government payors on all claims.
  2. Audits accounts for proper payments, coding, balances, adjustments, etc. using appropriate reports and work queues to do so.

10%

  1. Reviews all secondary claims prior to submission to ensure accuracy of claim and COB registration information.  If prior insurance pays more than Medicaid allowable when Medicaid is secondary, handles adjustments according to department procedures.

5%

  1. Complies with Federal and State billing requirements. Also complies with Health Information Portability and Accountability Act (HIPAA) and Electronic Data Interface (EDI) transaction formats.

5%

  1. Completes all requests and follow ups with medical records, pharmacy, etc. in order to ensure payments from third party payors.

5%

  1. Refers adjustments to reverse any discounts/contractual posted incorrectly, per department procedures

5%

  1. Keeps current on payor requirements though workshops, newsletters, and websites.

 

Regular attendance at work is an essential function of the job.

 

Perform physical requirements as described in the Physical Requirements section

SECONDARY FUNCTIONS/COMPETENCIES

5%

  1. Performs other duties as assigned

100%

 

 
KNOWLEDGE, SKILLS AND ABILITIES:
  • Organized, self-motivated, and able to work independently of direct supervision to carry out responsibilities
  • Knowledge of hospital and professional billing, collection and reimbursement requirements and standard practice.
  • Ability to review, interpret and understand managed care contracts and EOB’s with third-party payers to ensure appropriate reimbursement.
  • Intermediate computer skills including the use of spreadsheet programs and word processing programs.
  • Strong interpersonal skills with attention to detail and ability to organize, interpret, and present data.
  • Excellent oral and written communication skills as this position will deal directly with the public daily.
  • Ability to perform non-complex arithmetic calculations
EDUCATION AND EXPERIENCE:
  • High School diploma or GED equivalent required.
  • Minimum 2 years of experience working with commercial or government billing and reimbursement processes or Associate’s degree in Billing, Coding or HIM required
  • Associate’s degree in Billing, Coding, Business, Finance, or related filed preferred.

 

EOE/VETS/DISABLED

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Job Details

Date Posted May 22, 2020
Requisition 1328-5301
Address 8534 Cass Street
Located In Omaha, NE
Work At Cass 2
Department Central Billing Office
Job Type Full-time Employee
Shift
Daytime
M-F
Hours 40 hours per week
Start Date 2020-05-18
Positions Available 1
SOC Category 43-3021.03 Billing, Posting, and Calculating Machine Operators
Zipcode 68114

This job offers the following benefits

  • 403(b) Retirement Savings Plan
  • Dependent-Care Spending Accounts
  • Flexible Spending Accounts
  • Health-Care Spending Accounts
  • Accidental Death and Dismemberment
  • Business Travel Accident Insurance
  • Dental
  • Dependent Life Insurance
  • Employee Assistance Program (EAP)
  • Group Homeowners and Auto
  • Group Legal
  • Life Insurance
  • Long-Term Disability
  • Maternity / Paternity / Family Leave
  • Medical
  • Prescription Drug Plan
  • Short-Term Disability
  • Supplemental Insurance
  • Vision
  • Voluntary Life Insurance
  • Bereavement Pay
  • Cafeteria / Food
  • Continuing Education Program
  • Credit Union
  • Discounts on Employer Merchandise & Services
  • Employee Referral Program
  • Financial Planning
  • Free Parking
  • Health Fair
  • Nursing Facilities
  • Paid Holidays
  • Paid Vacations
  • Tuition Reimbursement
  • Wellness Program
  • Workout Facilities
  • Achievement Awards
  • Bonus Plan
  • Merit Increases

This job requires the following skills

  • Customer Service
  • Delinquent Account Collections
  • Computer Usage
  • Excellent Communications
  • Excellent Logic and Reasoning
  • Excellent Team Member
  • Problem Resolution
  • Medical Billing
  • Medical Coding
At a Glance
Enjoy these benefits
  • 403(b) Retirement Savings Plan
  • Dependent-Care Spending Accounts
  • Flexible Spending Accounts
  • Health-Care Spending Accounts
  • Accidental Death and Dismemberment
  • And More ...
Location