Billing Specialist

Community Action Partne•Gering, NE

9h•$16 - $18•Onsite

About The Position

Community Action Partnerships of Western Nebraska (CAPWN) is a non-profit community-based health and human services organization that serves low-income, disadvantaged and those unable to meet their needs through other sources. The agency was established in 1965 and provides services to over 9,000 individuals, children and families in three main areas: Community Health Services, Clinical Health Services, and Supportive Health Services. CAPWN's promise is to change people's lives, embody the spirit of hope, improve communities, and make America a better place to live. Their vision is communities where everyone has an opportunity for a successful life, and their mission is to provide quality services and promote learning opportunities to improve and nurture the health and well-being of Western Nebraska communities. Key beliefs include integrity, compassion, inclusion, collaboration, and innovation.

Requirements

High School diploma or GED required.
Ability to develop and utilize an understanding of medical terminology.
Have computer skills to navigate and input data into established medical software.
Have general knowledge and understanding of data collection processes.
Possess strong organizational skills, attention to detail and ability to work with high accuracy.
Have knowledge of and experience with billing first and third-party claims and management of accounts receivable and reporting criteria.

Nice To Haves

Two years’ experience with health-related billing processes preferred.
Four years’ experience with health-related billing processes.
Six years’ experience with health-related billing processes OR Hold an associate degree in Health Information Management or related degree.

Responsibilities

Responsible for all aspects of the Health Center’s billing including charge entry, general coding guidelines, payment posting, account receivables management, rejection, and denial management.
Work with patients to answer billing questions and concerns; facilitate error correction when needed or escalate to the appropriate internal party.
Maintain and update spreadsheets and tracking pertaining to account balances, aging, and claim rejections/denials accurately and timely.
Complete daily account billing: generate claims, mail claims or send electronically to appropriate insurance carrier. Routinely analyze and work claims that are rejected or denied.
Assure adjustments and payments are made appropriately and accurately in the Electronic Practice Management system.
Remain current with agency billing policies and ensure billing processes are following agency billing policies.
Assure timely identification of patient account credit balances and processing of refunds.
Manage accounts receivable by performing collection activity procedure to past due A/R accounts of insurance carriers and clients.
Make recommendations to the Billing Manager for problem resolution and identification of erroneous processes at the front end of the billing cycle and encounters.
Accurately document all activity taken in each patient’s account.
Maintain understanding of 3rd party billing hierarchy.
Maintain understanding of current coding and billing regulations and compliance requirements for the Bureau of Primary Health Care, Medicaid, Medicare, and private billing/insurance companies.
Remain current with ICD-10, CPT and HCPSS codes and users.
Participate in educational activities and attend regular team and agency meetings.
Maintain confidentiality of records and communications following HIPAA privacy and security policies and procedures.
As a CAPWN team member, dedicate your energy to providing high quality, value-added customer service and care to our clients. Embrace the CAPWN Standard of Behavior, practicing integrity, strong communication and respect for leaders and peers. Engage with the team and commit to improving and nurturing the health and well-being of the Western Nebraska Communities we serve.
All other duties as assigned.