Institutional & Profee Claims Biller - Medicaid

TheInstitutional & Profee Claims Biller is responsible for providingfull-cycle claims submission and follow-up/denial efforts.  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. Working claimsAND denial que's is part of this persons day-to-day responsibilities.

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 5 years hospital billing experience, to include; Charge Entry, Claim Review (prior to submission), Claim Submission, Claim Denials, Claim Re-Submission

• Experience processing Institutional and Profee claims isREQUIRED

• Experience processing Medicaid claims is ideal

• Excellent communication (written and oral) and interpersonal skills.

• 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 sills with a strong attention to detail, accuracy, and follow through

Why join our team?

• Work remotely with a work/life balance approach

• Robust benefits offering, including 401(k)

• Generous time off allotments

• 10 paid holidays annually

• Employer-paid short term disability and life insurance

• Paid Parental Leave