Patient Billing Rep II

Best CareOmaha, NE
3dOnsite

About The Position

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: Mon - Fri, 8:00am to 4:30pm Responsible for billing, electronic claims submission, follow up and collections of patient accounts.

Requirements

  • High school diploma, General Educational Development (GED) or equivalent required
  • Coursework in Coding, Billing or Healthcare Management normally acquired through enrollment in a secondary education institution or online classes through the American Heath Information Management Association (AHIMA) preferred.
  • Demonstration of knowledge and practice in medical terminology, third party payer appeals, denial trending and analysis, ICD-9, ICD-10, CPT4/HCPCS Coding, UB04 and CMS1500 claim data as supported by the Patient Billing Rep Skill Set Examination required.
  • Minimum of 1-2 years experience in a healthcare business office setting operating patient accounting software, electronic billing software and/or accessing payer websites required.
  • Ability to create and submit both original and corrected claims.
  • Skill in interpreting UB04 and/or CMS1500 claim data to be able to troubleshoot claim edits and resolve payer billing requirements both timely and accurately.
  • Ability to audit accounts and payer explanation of benefits (EOBs) to determine appropriate action.
  • Ability to maintain a working knowledge of multiple system applications.
  • Ability to use effective communication skills in order to handle patient inquires, attorneys, health system staff and payers on a professional level.
  • Knowledge and understanding of accounting and business principles to enable accurate auditing of patient accounts.
  • Ability to follow up with the 3rd party payers for claims and appeals submitted to ensure timely and accurate processing.
  • Ability to review and clearly articulate denial trends and patterns to identify potential opportunity to prevent denials and maximize reimbursement.

Nice To Haves

  • Prior experience interpreting contractual language preferred.

Responsibilities

  • UB04/837I and CMS1500/837P Claim Edit Handling/Billing/Interpretation
  • Display Effective Communication Skills
  • Handling of Referrals
  • Knowledge of System Applications
  • Auditing of Patient Accounts
  • Claim/Appeal Follow Up with Third Party Payers
  • Denial Trending and Analysis
  • Transaction Review/Posting
  • Special Projects and Tasks as Assigned
  • Maintaining Daily Workflow

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

High school or GED

Number of Employees

1,001-5,000 employees

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