Why work for Nebraska Methodist Health System
At Nebraska Methodist Health System we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care a culture that has and will continue to set us apart. Its helping families grow by making each delivery special conveying a difficult diagnosis with a compassionate touch going above and beyond for a patients needs or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay excellent benefits and a great work environment where all employees are valued! Most importantly our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary:

Responsibilities:

Essential Functions

Claims and Reimbursement Management (50%)

• Verify patient insurance coverage and eligibility for outofnetwork services.

• Confirm and document authorization with insurance companies for outofnetwork agreements.

• Update patient record to document the presence of a current authorization for timely billing.

Patient Financial Coordination (25%)

• Educate patients about their out of network benefits coverage limitations and estimated out of pocket costs.

• Assist patient with understanding Explanation of Benefits (EOBs) and billing statements.

• Work with out of network insurance companies to ensure proper authorization obtained for accurate billing and payment.

• Coordinate payment plans and financial assistance options when applicable and assist patient in connecting with a financial counselor.

Provider and Clinic Support (25%)

• Collaborates with clinic staff physicians registration staff and hospital billing departments to ensure proper documentation and coding for out of network claims.

• Communicates with Physician Partners the authorization status of the patient potentially working with a variety of sites of service to arrange.

• Stay up to date on policies and regulatory requirements to ensure compliance.

• Analyze reimbursement trends and recommend strategies to optimize out of network revenue.

• Routinely monitor department compliance metrics and assist with identification of performance improvement opportunities.

Schedule:

MondayFriday 8a4:30p

Job Description:

Job Requirements

Education:

Associate or bachelors degree in healthcare administration business or related field preferred.

Experience:

Two plus years experience in healthcare related field outpatient clinical care medical billing or insurance claims preferred.

License/Certification:

• NA

Skills/Knowledge and Abilities:

• Working knowledge of the healthcare insurance managed care and its terminology.

• Excellent communication skills both written and verbal.

• Collaborative and engages with the client and team members effectively.

• Proficiency in healthcare billing software and electronic medical records. (EMR).

• Organized with strong ability to meet deadlines plan and optimize daily operations.

• Attention to details ensuring accuracy in documentation reporting and execution.

Physical Requirements

Weight Demands

• Medium Work Exerting up to 50 pounds of force.

Physical Activity

• Not necessary for the position (0%):

  • Climbing

  • Crawling

  • Kneeling

• Occasionally Performed (1%33%):

  • Balancing

  • Carrying

  • Crouching

  • Distinguish colors

  • Grasping

  • Lifting

  • Pulling/Pushing

  • Standing

  • Stooping/bending

  • Twisting

  • Walking

• Frequently Performed (34%66%):

  • Keyboarding/typing

  • Reaching

  • Repetitive Motions

  • Sitting

  • Speaking/talking

• Constantly Performed (67%100%):

  • Hearing

  • Seeing/Visual

Job Hazards

• Not Related:

  • Chemical agents (Toxic Corrosive Flammable Latex)

  • Equipment/Machinery/Tools

  • Explosives (pressurized gas)

  • Electrical Shock/Static

  • Radiation Alpha Beta and Gamma (particles such as Xray Cat Scan Gamma Knife etc.)

  • Radiation NonIonizing (Ultraviolet visible light infrared and microwaves that causes injuries to tissue or thermal or photochemical means)

  • Mechanical moving parts/vibrations

• Occasionally (34%66%):

  • Biological agents (primary airborne and blood born viruses) (Jobs with Patient contact) (BBF)

  • Physical hazards (noise temperature lighting wet floors outdoors sharps) (more than ordinary office environment)

About Methodist:

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa more than 30 clinic locations a nursing and allied health college and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891 service to our communities has been a top priority. Financial assistance health education outreach to our diverse communities and populations and other community benefit activities have always been central to our mission.

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race color religion sex age national origin disability veteran status sexual orientation gender identity or any other classification protected by Federal state or local law.