Medical Billing Sr Associate (Evergreen)

The Nebraska Medical Center•Omaha, NE

About The Position

The Medical Billing Sr Associate ensures timely submission of accurate claims data and timely, accurate account follow-up—including adjustment claims, reconsiderations, and adjustment requests—to facilitate prompt and accurate payment from third-party payers and others. The role performs daily reconciliation of claim submissions, processes rejects within 24 hours, and works with external departments as needed to resolve claim issues before submission. The associate makes decisions to ensure account accuracy, limit denials, and bill patients and primary, secondary, and tertiary payers on time. This is a first-shift position. Start times may range from 6:00 a.m. to 9:00 a.m., Monday through Friday, provided eight hours are worked by 5:30 p.m.

Requirements

High school education or equivalent.
At least two years of higher education with coursework in a relevant field such as business or healthcare, or an equivalent combination of education and experience in a relevant professional setting.
Multi-tasking and problem-solving abilities.
Strong verbal and written communication skills.
Strong organizational skills and aptitude for detail-oriented work.
Experience using Microsoft products, specifically Word and Excel.
Ability to type at least 30 words per minute with 95% accuracy.

Nice To Haves

Prior experience in healthcare billing and collections.
Associate's degree in business administration or college-level business coursework.
Knowledge of Correct Coding Initiative (CCI), Outpatient Code Editor (OCE), National Coverage Determinations (NCD), and Local Coverage Determinations (LCD) edits.
Knowledge of third-party payer edits.
Working knowledge of medical terminology and International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) coding.
Knowledge of databases and flowcharting processes.

Responsibilities

Ensure timely submission of accurate claims data.
Perform timely and accurate account follow-up, including adjustment claims, reconsiderations, and adjustment requests.
Reconcile claim submissions daily.
Process rejected claims within 24 hours.
Work with external departments as needed to resolve claim issues before submission.
Make decisions that support account accuracy, limit denials, and ensure timely billing of patients and primary, secondary, and tertiary payers.