Patient Financial Billing Specialists
Patient Financial Billing Specialists
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Salary Not Disclosed
1 Vacancy
Job Description
Overview
Now Hiring a Patient Financial Billing Specialist
Accurately processes all insurance claims for all payers types including Government payers Research grants and Occ Medicine. Analyzes interprets and resolves all billing edits to ensure claims are filed accurately within the payers regulations and filing limits. Adheres to compliance and regulatory rules as mandated by CMS state and federal regulations payer contracts and established department policies and procedures. Works closely with cash team to resolve unapplied cash credit balances or other posting issues. Contacts patient/members directly regarding eligiblity errors or to complete MSPQ in order to resolve outstanding billing edits. Research analysises and follows up on all payer edits / rejections ensuring accurate and timely claim submission. Peforms a variety of duties that includes the use of payer web pages or calls insurance companys to resolve billing issues. May followup on balances due from insurance. Responsible for the handling of all correspondance related to the billing of a claim for all lines of business answers questions and updates accounts as necessary. Responsible for submission of all electronic claims through PCbased processing system. Submits paper claims to nonelectronic carriers with required documentation. Responsible for correcting any errors made by other department to ensure claimes are submitted correctly. Contacts payers to determine benefit eligibilty and coverage.
How you belong matters here.
We value our employees differences and find strength in the diversity of our team and community.
At Presbyterian its not just what we do that matters. Its how we do it and it starts with our incredible team. From Information Technology to Food Services and beyond our nonclinical employees make a meaningful impact on the healthcare provided to our patients and members.
Why Join Us
- Full Time Exempt: No
- Job is based Rev Hugh Cooper Admin Center
- Work hours: Weekday Schedule MondayFriday
- Benefits: We offer a wide range of benefits including medical wellness program vision dental paid time off retirement and more for FT employees.
Ideal Candidate: Minimum 1 year experience in medical claim processing and/or insurance billing for hospital physician or hospice.
Qualifications
- High School Diploma or GED
- Minimum 1 year experience in medical claim processing and/or insurance billing for hospital physician or hospice.
- One year experience in a computerized account receivable system required. Experience with Microsoft Office Suite products internet and automated billing systems such as Epic and Medassets is preferred.
- Excellent organizational problem solving solid verbal and written communication attention to detail and the ability to interact effectively with other functional areas and management team is required.
- Must have a strong work ethic and demonstrated ability to work effectively in a team environment.
- Must be able to prioritize and manage a high volume workload.
- Detailed knowledge of ICD10 HCPCS CPT codes
- Revenue Codes UB04 and HCFA 1500 claim forms and an understanding of electronic processing of 837 and 835 is preferred.
- Detailed knowledge of Coordination of benefits and the Medicare MSPQ required.
- Must have thorough knowledge of various payer requirements claim submission processes for major insurances carriers and intermediaries and knowledge of the revenue cycle processes in terms of what and how work is processed.
Responsibilities
- Responsible for managing the workflow consisting of all unbilled claims.
- Must bill all claims timely and accurately according to patient accounting departments policies and procedures as well as payer requirements.
- Resolves prebilling edits for compliant and accurate billing to ensure claims are billed correctly.
- Performs both electronic and paper claim processing for primary and secondary claims along with attachments medical records mail and appropriate forms for payers following HIPPA requirements.
- Documents accounts in accordance with established PHS policies and procedures.
- Responsible for contacting insurance companies patients or employer groups regarding unbilled claims needing information to submit claim.
- Must work closely with outside agencies contracted with Patient.
- Accounting as well as internal PHS departments and assist with claim related billing issues.
Benefits
All benefitseligible Presbyterian employees receive a comprehensive benefits package that includes medical dental vision shortterm and longterm disability group term life insurance and other optional voluntary benefits.
Wellness
Presbyterians Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your wellbeing. Earn gift cards and more by taking an active role in our personal wellbeing by participating in wellness activities like wellness challenges webinar preventive screening and more.
Why work at Presbyterian
As an organization we are committed to improving the health of our communities. From hosting growers markets to partnering with local communities Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients members and the communities we serve. We are locally owned notforprofit healthcare system of nine hospitals a statewide health plan and a growing multispecialty medical group. Founded in New Mexico in 1908 we are the states largest private employer with nearly 14000 employees including more than 1600 providers and nearly 4700 nurses.
Our health plan serves more than 580000 members statewide and offers Medicare Advantage Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drugfree and tobaccofree employer with smoke free campuses.
Maximum Offer for this position is up to
Compensation Disclaimer
Required Experience:
Unclear Seniority
Employment Type
Full-Time
