CCMC Biller (Patient Account Rep)

OHSU is Oregons only public academic health center. We are a system of hospitals and clinics across Oregon and southwest Washington. We are an institution of higher learning with schools of medicine nursing pharmacy dentistry and public health and with a network of campuses and partners throughout Oregon. We are a national research hub with thousands of scientists developing lifesaving therapies and deeper understanding. We are a statewide economic engine and Portlands largest employer. And as a public organization we provide services for the most vulnerable Oregonians and outreach to improve health in communities across the state.

The role of a CCMC Biller (Patient Account Rep) is to bill process adjustments collect on accounts and/or perform customer service duties to ensure that monies due University Hospital are secured and paid in a timely manner and the AR outstanding days of revenue arekept to a minimum. Assignment will be flexible depending on payor mix patient flow and workloadfluctuation

• Billing to all non-government payors (to include medical insurers autoinsurers workers compensation insurers managed care contracts specialgrants government agencies)
  • Prepare timely and accurate on-line and paper claims (UB-04s 1500s and dental bills) to third party payors. Research any missingor incorrect data using Document Imaging LCR PMS andSignature. Request copies of medical records as necessary. Reviewall claims for electronic edits (to include CPT HCPCS and ICD-10 coding) and accuracy and make corrections as inpatient interims and outpatient bills over $500 are to bemailed same day as printed. Outpatient claims under $500 must bebilled within 5 days of printing or be documented as to delay and resolution.
  • Document the billing on all inpatient day surgery observation and ed cases.
  • Process up front contractual allowances using cheat sheets contracts and Ascent.
  • Bill secondary payors using the different rules for COB as dictated by state regulations and contractual agreements.
  • Prepare special billing documents as needed by agencies.
  • Document all non-covered services forms.
  • Complete all work following HIPAA regulations
  • Review web-based eligibility systems (USSP ODS Benefits Tracker etc.) to confirm eligibility and correct insurance plan coding. Update accounts as necessary.

• Third party follow-up and collection:

  • Review previous admissions/accounts and/or making phone calls toverify the validity of the insurance plan code.

  • Review claims that are returned due to incomplete or incorrect addresses

• Other duties as assigned within the scope of the established class specs. Toalso include activities that are classified as team support and environmentalactivities

• Two years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office;OR

• Four years of general collection billing or customer service experience; OR

• Equivalent combination of education and experience.

• Certified Revenue Cycle Specialist (CRCS) is required within 18 months ofhire.

• Recent (within one year of date of hire) Microsoft Office Suite experience in Windows environment with skill in document production using WORD spreadsheet construction in EXCEL.
• Experience in billing Hospital claims or UB-04 claims.
• Knowledge of and experience in interpreting managed care contracts.
• Familiarity with DRG CPT HCPC and ICD-10 coding

Job Related KnowledgeSkills and Abilities(Competencies):

• Typing 45 wpm
• Ability to use multiple system applications
• Demonstrated ability to communicate effectively verbally or in writing.
• Demonstrated ability to process detail oriented and analytical work.
• Demonstrated ability to prioritize and accomplish multiple tasks in a fast-paced environment; consistently adhering to defined due date