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

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