Patient Billing/Follow up Rep

Best Care • Omaha, NE

3d • Onsite

About The Position

Why work for Nebraska Methodist Health System? At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in. Job Summary: Location: Methodist Corporate Office Address: 825 S 169th St. - Omaha, NE Work Schedule: Monday - Friday Responsible for billing, electronic claims submission, follow up and collections of patient accounts.

Requirements

• High school diploma, General Educational Development (GED) or equivalent required
• 1-2 years of experience in health care third party billing and/or claims processing preferred.
• Requires basic navigation skills in Microsoft Office applications, including Outlook, Excel, Powerpoint and Word.
• Requires the ability to learn how to prepare and process third-party billing to include the ability to read an explanation of benefit and account auditing experience.
• Requires the ability to navigate, obtain information online.
• Requires the ability to learn & maintain working knowledge of the following systems: Cerner Patient Accounting, Revenue Manager, Medicare Online System (FISS), MREP, PC Print and/or all Payers Websites.
• Requires analytical ability to review accounts to determine appropriate action.
• Requires effective communication skills for handling patient's, attorneys; inter departmental staff and Insurance Companies at a professional level.
• Requires the ability to understand basic accounting and business principals to enable accurate auditing of patient accounts, execution of claims scrubbers and ability to read EOB's.

Nice To Haves

• Preferred knowledge of ICD-9, ICD-10, CPT-4 and HCPCS coding.

Responsibilities

• Bills all non-EDI Primary Health Plans both UB04 & 1500. All claims billed on a daily basis are to be submitted same day unless there is a system problem. Submits claims according to payer specific guidelines. Ensures claims are submitted to appropriate Payer physical address.
• Bills all health plans electronically, both UB04's and/or 1500's in an accurate and timely manner for appropriate reimbursement. All claims are to be billed daily with exception of claims Pended, on Hold or if system problems. Exception claims must be fully documented. Submits claims according to payer specific guidelines.
• Prepares secondary and tertiary billings, manually and electronically on UB04's and 1500's for accurate reimbursement. Obtains appropriate EOB's through use of Resources - Intenal/External Electronic systems listed: MREP, Application Xtender, Revenue Manager, PC Print, QMS and/or Individual Payer Websites. Claims billed in the time frame set by Department Submits claims according to Payer specific guidelines.
• Reviews Claims and determines appropriate action to be taken by understanding and navigating the Electronic Billing Software. Daily prioritize, sort and maintain claims based on status for timely handling. ie: Rejects/Invalids/Pends/Denied and Holds. Identifies and works electronic claim edits from a payer perspective. Reviews Revenue Manager Claim Detail Screens to ensure data is appropriate for claim submission. Ensure that claim corrections identified in Rev Manager are appropriately updated in Source System.
• Review and Follow Up of accounts to ensure appropriate 3rd Party Payer reimbursement is received through to closure of Account. Prioritize, maintain 11 Workflow Queues on daily basis. Appropriate use of resources: Internet, Record Link, Powerchart, Telephone, All Payer Websites, FISS, Email to obtain information to resolve patient accounts. Ensure Daily/Weekly/Monthly Reports are accurately and timely. Perform audits on all accounts to verify balance is accounted for and appropriate action is taken.
• Processes all daily Mail and Referrals received in an accurate and timely manner. Mail/Correspondence to be processed following department guidelines of 5 days from receipt. Referrals to be processed following department guidelines of 5 days from initial receipt. Documents in the appropriate records system any action taken in handling accounts. Appropriate documentation in Source system when necessary Complete and accurate documentation must be added immediately following action taken on accounts Who, what, where, when documentation method ID used in documentation process. Uses proper abbreviations and demonstrates professionalism and consistency in documentation.
• Patient complaints are handled in a timely and appropriate fashion. Works patient complaints as a high priority within 24 hours. Notifies patient of final results of account handling in question in a timely manner. Documentation of all patient calls. Professional courtesy expected when working directly with patient. Consistent handling of Telephone calls. Professional/Courteous responses when communicating with customers both internal & external. Timely follow up with responses. Proper use of Telephone by following department guidelines on personal use of business telephone.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees