Acute Claim Biller - UB04 & CMS-1500 (eClinicalWorks)

Job SummaryThe Acute Claim Biller - UB04 & CMS-1500 (eClinicalWorks) position is responsible for day-to-day execution of complete business office services. This position is responsible for providing claims processing services to Critical Access Hospital (UB-04) and Rural Health Clinic (CMS-1500) facilities. This includes coordinating the day to day activities of a hospital's or clinic’s business office such as patient billing and collection, third-party payer relations, and/or preparation of insurance claims.

Essential Functions:

In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

• Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry.
• Recommends new processes and changes in current processes.
• Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures
• Implements appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts
• Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third-party requirements
• Responsible for consistently meeting production and quality assurance standards
• Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
• Updates job knowledge by participating in company offered education opportunities
• Protects customer information by keeping all information confidential
• Processes miscellaneous paperwork
• Ability to work with high profile customers with difficult processes
• May regularly be asked to help with team projects
• Responsible for assisting manager in the management of employees which would include coaching, training and performing necessary disciplinary actions including following up on action plans for their employees.
• Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
• Ensures employee compliance with dress code, attendance and other company policies.
• Processes miscellaneous paperwork and performs other administrative duties as assigned.

Minimum Requirements:

Education/Experience/Certification Requirements

• At least 3-5 years Full-Cycle billing experience, to include BOTH Acute Hospital and Physician (Profee) claims
• Experience with Claims AND Denial work queue's
• Experience using eClinicalWorks E.M.R - REQUIRED
• Familiar with Commercial, Workers Comp, and VA claims REQUIRED
• Strong organizational, multi-tasking, and time-management skills.
• Must be detail oriented and able to follow through on issues to resolution.
• Must be able to act both independently and as a team member.
• High School Diploma or equivalent combination of education and relevant experience needed.
• Excellent critical thinking, organizational, and time management skills with a strong attention to detail, accuracy, and follow through

Originally posted on Himalayas