INSTITUTIONAL & PROFEE CLAIMS BILLER - MEDICAID

Cpsi

Full-timesenior

Job description

<div></div><div>The Institutional & Profee Claims Biller is responsible for providing full-cycle claims submission and follow-up/denial efforts. 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. Working claims AND denial que's is part of this persons day-to-day responsibilities.Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:<ul><li>Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry.</li><li>Recommends new processes and changes in current processes.</li><li>Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures</li><li>Implements appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts</li><li>Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third-party requirements</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>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.</li><li>Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer</li><li>Ensures employee compliance with dress code, attendance and other company policies.</li><li>Processes miscellaneous paperwork and performs other administrative duties as assigned.</li></ul>Minimum Requirements:Education/Experience/Certification Requirements<ul><li>At least 5 years hospital billing experience, to include; Charge Entry, Claim Review (prior to submission), Claim Submission, Claim Denials, Claim Re-Submission</li><li>Experience processing Institutional and Profee claims is REQUIRED</li><li>Experience processing Medicaid claims is ideal</li><li>Excellent communication (written and oral) and interpersonal skills.</li><li>Strong organizational, multi-tasking, and time-management skills.</li><li>Must be detail oriented and able to follow through on issues to resolution.</li><li>Must be able to act both independently and as a team member.</li><li>High School Diploma or equivalent combination of education and relevant experience needed. </li><li>Excellent critical thinking, organizational, and time management sills with a strong attention to detail, accuracy, and follow through</li></ul>Why join our team? <ul><li>Work remotely with a work/life balance approach</li><li>Robust benefits offering, including 401(k)</li><li>Generous time off allotments</li><li>10 paid holidays annually</li><li>Employer-paid short term disability and life insurance</li><li>Paid Parental Leave</li></ul></div>Business Support