Role Description
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 clinicβs business office such as patient billing and collection, third-party payer relations, and/or preparation of insurance claims.
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Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry.
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Recommends new processes and changes in current processes.
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Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures.
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Implements appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts.
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Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third-party requirements.
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Responsible for consistently meeting production and quality assurance standards.
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Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer.
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Updates job knowledge by participating in company offered education opportunities.
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Protects customer information by keeping all information confidential.
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Processes miscellaneous paperwork.
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Ability to work with high profile customers with difficult processes.
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May regularly be asked to help with team projects.
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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.
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Ensures employee compliance with dress code, attendance and other company policies.
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Processes miscellaneous paperwork and performs other administrative duties as assigned.
Qualifications
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At least 3-5 years Full-Cycle billing experience, to include BOTH Acute Hospital and Physician (Profee) claims.
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Experience with Claims AND Denial work queue's.
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Experience using eClinicalWorks E.M.R - REQUIRED.
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Familiar with Commercial, Workers Comp, and VA claims - REQUIRED.
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Strong organizational, multi-tasking, and time-management skills.
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Must be detail oriented and able to follow through on issues to resolution.
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Must be able to act both independently and as a team member.
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High School Diploma or equivalent combination of education and relevant experience needed.
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Excellent critical thinking, organizational, and time management skills with a strong attention to detail, accuracy, and follow through.