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Patient Billing Rep I $1000 Sign on Bonus!!

Methodist Health System Omaha, NE
  • Purpose of Job
    • Responsible for billing, electronic claims submission, follow up and collections of patient accounts.
  • Job Requirements
    • Education
      • High school diploma, General Educational Development (GED) or equivalent required
      • Coursework in Coding, Billing or Healthcare Management normally acquired through enrollment in a secondary education institution or online classes through the American Heath Information Management Association (AHIMA) preferred.

    • Experience
      • Minimum of one (1) year prior experience in healthcare third party billing and/or claims processing preferred.
      • Prior exposure to UP04 and/or CMS1500 claim data normally acquired through work in a physician’s office or other healthcare setting preferred.

    • License/Certifications
      • N/A

    • Skills/Knowledge/Abilities
      • Skill in interpreting UB04 and/or CMS1500 claim data to be able to troubleshoot claim edits and resolve payer billing requirements both timely and accurately.
      • Ability to create and submit both original and corrected claims.
      • Ability to audit accounts and payer explanation of benefits (EOBs) to determine appropriate action.
      • Ability to use effective communication skills in order to handle patient inquires, attorneys, health system staff and payers on a professional level.
      • Knowledge and understanding of accounting and business principles to enable accurate auditing of patient accounts.
      • Ability to follow up with the 3rd party payers for claims and appeals submitted to ensure timely and accurate processing.
      • Ability to maintain a working knowledge of multiple system applications.
  • Physical Requirements
    • Weight Demands
      • Light Work - Exerting up to 20 pounds of force.

    • Physical Activity
      • Occasionally Performed (1%-33%):
        • Balancing
        • Climbing
        • Carrying
        • Crawling
        • Crouching
        • Distinguish colors
        • Kneeling
        • Lifting
        • Pulling/Pushing
        • Reaching
        • Standing
        • Stooping/bending
        • Twisting
        • Walking
      • Frequently Performed (34%-66%):
        • Hearing
        • Repetitive Motions
        • Seeing/Visual
        • Speaking/talking
      • Constantly Performed (67%-100%):
        • Fingering/Touching
        • Grasping
        • Keyboarding/typing
        • Sitting

    • Job Hazards
      • Not Related:
        • Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (BBF)
        • Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)
        • Equipment/Machinery/Tools
        • Explosives (pressurized gas)
        • Electrical Shock/Static
        • Radiation Alpha, Beta and Gamma (particles such as X-ray, Cat Scan, Gamma Knife, etc)
        • Radiation Non-Ionizing (Ultraviolet, visible light, infrared and microwaves that causes injuries to tissue or thermal or photochemical means)
      • Rare (1-33%):
        • Chemical agents (Toxic, Corrosive, Flammable, Latex)
        • Mechanical moving parts/vibrations
      • Note: Safety Officer can assist with identification of job hazards
  • Essential Job Functions
    • Essential Functions I

      • Electronic and Hardcopy Billing
        • All EDI and paper claims submitted are to be billed as needed following department and payer specific guidelines.
        • Obtains appropriate EOB's through use of health system resources.
        • Reviews Billing Scrubber Claim Detail Screens to ensure data is appropriate for claim submission.
        • Ensure that claim corrections identified in billing scrubber are appropriately updated and documented in Source System.
        • Prepares secondary and tertiary billings, manually and electronically on UB04's and/or 1500's for accurate reimbursement.
        • Submits adjusted UB04/837I and/or CMS1500/837P claims according to department and payer specific guidelines.

      • Display Effective Communication Skills
        • Demonstrates active listening skills.
        • Notifies and keeps leads and supervisors informed on issues identified.
        • Follows telephone etiquette procedures set forth by the organization and/or individual department.
        • Professional/Courteous responses when communicating with customers, health system staff and management.

      • Handling of Referrals
        • Timely and accurately handling of referrals, both regular and escalated priority from management, within department guidelines.
        • Documents clearly and appropriately all referrals (including patient inquiries) in the Source System when necessary.
        • If necessary, follows up with patients on final results of inquiry both timely and professionally.  Notifies patient of final results of account handling in question.

      • Knowledge of System Applications
        • Demonstrates ability to learn and maintain a working knowledge on all the current health system applications.
        • Identify/obtain/print medical records as necessary for resolution of denial or system edits according to department guidelines.

      • Auditing of Patient Accounts
        • Understand accounting and business principles to accurately determine the remaining balance on a given encounter.
        • Upon accurately auditing encounter or visit, is able to understand and update proration to make sure dollars are allocated to the appropriate benefit orders if needed.
        • Leverages all needed resources to complete an audit of an account.
        • Documents audit finding and actions taken in Source System when necessary.

      • Claim Follow Up with Third Party Payers
        • Full understanding of all necessary third party billing and follow up processes based on department specifications.
        • Full understanding of all necessary contract related requirements.
        • Leverages payer websites and necessary tools to streamline the follow up process.
        • Appropriate documentation in Source System when necessary.
        • Ability to interpret correspondence assigned for accurate handling.

      • Special Projects and Tasks as Assigned
        • Completion of any assigned projects timely, accurately and to the specifications of leadership.
        • Ensure Daily/Weekly/Monthly assignments are handled accurately and timely.

      • Maintaining Daily Workflow
        • Manages and maintains assigned workflow queues according to department guidelines.
        • Mail/Correspondence processed and handled following departmental guidelines.
        • Documents both timely and appropriately in Source System using proper documentation methods.
        • Fundamental understanding of different work item, state based and exception queues within the Patient Accounting System applications.

    • Essential Functions II

      • Participates in mandatory in-services and/or CE programs as mandated by policies and procedures/external agencies and as directed by management.

      • Follows and understands the mission, vision, core values, Employee Standards of Behavior and company policies/procedures.

      • Other duties as assigned.

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Date Posted August 5, 2022
Date Closes October 4, 2022
Requisition 24411
Located In Omaha, NE
SOC Category 00-0000.00

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