[Hiring] Hospital Biller 2 @Inland RCM

Role Description

Address large volume of unpaid or incorrectly paid/denied claims to secure reimbursement.

• Performs medical billing functions as related to both institutional and professional claims.
• Reviews and resolves claim edits and rejections and resubmits clean claims.
• Reviews unpaid claims, including denials, and appropriately resolves and resubmits adjusted/corrected claims.
• Researches and/or resolves overpayments/credit balances.

Essential Duties/Responsibilities:

• Responsible for all phases of billing to government and commercial insurers, including initial billing of clean claims electronically or on paper, subsequent follow up on unpaid claims to the point of payment or resolution of the claim, and resolving credit balances.
• Prioritizes assigned worklist of aged accounts appropriately and works on aging accounts to their resolution.
• Reviews and processes electronic claims, claim edits and deletions appropriately and compliantly.
• Interprets billing regulations accurately and within federal, state, and third-party billing regulations and policies.
• Utilizes various client host systems in order to research and rebills claims.
• Other special projects and duties as assigned.

General Duties/Responsibilities:

• Ability to maintain strict confidentiality within the Inland Imaging companies and IRCM customers.
• Follows all Health and Safety policies and guidelines of IRCM.
• Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.
• Honest, pleasant manner and good personal hygiene.
• Free of alcohol and drug abuse.
• Ability to access multiple worksites in a timely manner.
• Excellent communication and interpersonal skills.
• Detail oriented; ability to multi-task; organized and able to work in a fast paced environment.
• Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.
• Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
• Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.
• Follows all Health and Safety policies and guidelines of Inland Imaging and its partners depending on work location.
• Performs other duties as required by displaying team spirit and self-growth, accepting and performing other projects and responsibilities, and requesting other projects and responsibilities.
• Attendance is required for this position.
• Rotates to other shifts and locations as needed.

Supervisory Responsibilities:

• There is little or no supervisory responsibility in this position.

Advocacy:

• Treats all clients with dignity and respect.
• Provides excellent customer service.
• Conforms to Joint Commission and HIPAA regulations.
• Complies with PHI (Protected Health Information).
• Demonstrates the IRCM values by knowing and understanding the mission, values and goals.

Qualifications

• High School Diploma/GED required.
• Two-year medical billing course successful completion is desired.
• At least five years of experience in billing medical claims to either government or commercial insurers.
• Preferably has experience in hospital billing, but will accept equivalent in physician, clinic, or ASC billing.
• Working knowledge of government hospital payment methodologies including OPPS, Critical Access Hospital method II, or both preferred.
• CPT, HCPCs and ICD-10 coding experience preferred.
• Experience with electronic claims scrubbing and clearinghouse systems preferred.

Requirements

• A certification related to healthcare claims processing from a recognized industry accrediting body (AHIMA, AAPC, etc.) upon start of job, or obtained within 6 months of start of job.
• Experience with Microsoft Office products (Outlook, Word, Excel), Internet/Intranet, Meditech, Epic or other hospital or physician EHR/accounting system.
• Ability to work from a remote (home) based environment if requested. Need to have a dedicated workspace with desk, desk chair, and access to cable internet.
• Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults.
• All new employees of Inland Imaging Business Associates will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG).
• Eligible employees must be able to pass a post-offer, pre-employment drug test.