PB EPIC CLAIMS BILLER

<p><b>Job Summary:</b></p><p>The <i>PB Epic Claims Biller</i> position is responsible for acting as a liaison for hospitals and clinics using TruBridge’s complete business office services. They work closely with TruBridge management and hospital employees to bill insurance companies for all <b>hospital</b>, <b>hospital-based physician</b> and <b>clinic bills</b>. They pursue collection of all claims until payment is made by insurance companies; and perform other work associated with the billing process.</p><p></p><p>These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job related duties as required.  Goals and objectives are subject to change.</p><p></p><p>All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate. </p><p></p><p><b>Essential Functions:</b></p><p>In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:</p><ul><li>Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing.</li><li>Secures needed medical documentation required or requested by third party insurances.</li><li>Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.</li><li>Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers.</li><li>Responsible for consistently meeting production and quality assurance standards.</li><li>Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer.</li><li>Updates job knowledge by participating in company offered education opportunities.</li><li>Protects customer information by keeping all information confidential.</li><li>Processes miscellaneous paperwork.</li><li>Ability to work with high profile customers with difficult processes.</li><li>May regularly be asked to help with team projects.</li><li>Ensure all claims are submitted daily with a goal of zero errors.</li><li>Timely follow up on insurance claim status.</li><li>Reading and interpreting an EOB (Explanation of Benefits).</li><li>Respond to inquiries by insurance companies.</li><li>Denial Management.</li><li>Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles.</li><li>Review late charge reports and file corrected claims or write off charges as per client policy.</li><li>Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy.</li><li>Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer.</li></ul><p></p><p><b>Minimum Requirements:</b></p><p>Education/Experience/Certification Requirements</p><ul><li>3 years of physician/ambulatory billing (Full Cycle) experience <b>REQUIRED</b></li><li>PB Epic experience <b>REQUIRED (within the past 3 years)</b></li><li>Computer skills.</li><li>Experience in CPT and ICD-10 coding.</li><li>Familiarity with medical terminology.</li><li>Ability to communicate with various insurance payers.</li><li>Experience in filing claim appeals with insurance companies to ensure maximum reimbursement.</li><li>Responsible use of confidential information.</li><li>Strong written and verbal skills.</li><li>Ability to multi-task.</li></ul>Business Support