Billing Representative

Essentia Health•Deer River, MN

About The Position

Processes paper and electronic claims to payers with full and complete information to facilitate payment. Produces accurate and timely claims to prevent denials and maximize reimbursement. Works assigned work queues in the patient accounting system and addresses claim-scrubber edits before final submission. Reviews submissions prospectively and makes corrections to optimize claim submission and expedite first-time payment where possible. Researches and communicates payer, HIPAA, and other regulatory changes affecting health insurance claim billing, and recommends improvements to billing and system operations. Works closely with insurance companies, credentialing, access, managed care, and other internal and external stakeholders connected to the billing system. Recommends system changes to improve revenue-cycle processes and quality and assists with training development. Requires strong customer-service skills to establish and enhance positive relationships with patients, colleagues, and others. Duties may vary by location and may include other work of similar scope and responsibility.

Requirements

High-level customer-service skills to establish and enhance positive relationships with patients, colleagues, and others.

Nice To Haves

One year of experience in healthcare billing, revenue services, or coding.
Medical certification or degree.

Responsibilities

Process complete paper and electronic claims for submission to payers.
Produce accurate and timely claims to prevent denials and maximize reimbursement.
Work assigned patient-accounting-system queues and resolve claim-scrubber edits before final submission.
Prospectively review claim submissions and make corrections to help expedite first-time payment.
Research and communicate payer, HIPAA, and other regulatory changes affecting health insurance claims.
Recommend improvements to billing and system operations and to the revenue-cycle process and quality.
Coordinate with insurance companies, credentialing, access, managed care, and other internal and external stakeholders.
Assist with development of training.
Provide high-level customer service to patients, colleagues, and others.