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Job Summary The 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
