Pre-Billing Claims Specialist - Northwest Billing

Surgery Partners Careers • Post Falls, ID

1d • Onsite

About The Position

Northwest Specialty Hospital is seeking a detail-oriented Pre-Billing Claims Specialist to join our Billing Team! We need someone with a professional demeanor, can work well under stress/stress situations, will provide great customer service, and can multitask! Under the direction of the Revenue Cycle Manager, the Pre-Billing Claims Specialist will submit and process claims in accordance with payer regulations and department policies and procedures. This position will ensure proper follow up of unbilled accounts using Meditech worklists; contact patient for insurance information and or clarification as needed before initial bill. Perform other duties as assigned and/or assume additional responsibilities as required. Advanced knowledge of coordination of benefits and Medicare Secondary Payer requirements. Verify patient coverage for primary, secondary and tertiary, verify third party billing and or auto insurance information as necessary, ensure the authorization number is in the required field, ensure secondary and tertiary claims have generated for billing, ensure electronic claim files are created and uploaded. This position will also work to resolve Meditech claim edits, work external Clearinghouse prebilling and payer rejections, and work with Team Lead and Clearinghouses to establish custom edits and resolve errors.

Requirements

• High school diploma or equivalent required
• Proficient with billing and prebilling: Medicare, Medicaid, BCBS, and Commercial
• Proficient with billing UB04s and HCFAs
• Excellent communication skills; required for both written and verbal
• Analytical; ability to research, analyze and train on data and reports
• Minimum of 2 years’ physician & facility billing experience
• Professional demeanor
• Can work well under stress/stress situations
• Provide great customer service
• Can multitask
• Advanced knowledge of coordination of benefits and Medicare Secondary Payer requirements

Responsibilities

• Submit and process claims in accordance with payer regulations and department policies and procedures.
• Ensure proper follow up of unbilled accounts using Meditech biller worklists.
• Contact patient for insurance information and or clarification as needed before initial bill.
• Perform other duties as assigned and/or assume additional responsibilities as required.
• Verify patient coverage for primary, secondary and tertiary.
• Verify third party billing and or auto insurance information as necessary.
• Ensure the authorization number is in the required field.
• Ensure secondary and tertiary claims have generated for billing.
• Ensure electronic claim files are created and uploaded.
• Resolve Meditech claim edits.
• Work external Clearinghouse prebilling and payer rejections.
• Work with Team Lead and Clearinghouses to establish custom edits and resolve errors.

Benefits

• Comprehensive health care coverage with options for Medical, Dental, & Vision Insurance
• Tuition reimbursement
• Growth opportunities, ongoing education, training, leadership courses
• A generous 401K retirement plan
• A variety of discounts throughout the hospital and community are available to employees
• Wellness benefits offered to staff such as: weight loss challenge, access to a dietitian, and discount gym memberships
• Culture that promotes and supports work/life balance
• Company-sponsored events such as Silverwood Days, sporting events, BBQs and holiday parties

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED