Biller - Claims & Denials - Full-Cycle Biller

CPSI
  • CA
    4 days ago

    Job Description

    The Full-Cycle Biller is responsible for providing TruBridge claims processing services to Critical Access Hospital (UB-04) and Rural Health Clinic (CMS-1500) facilities in New Hampshire. 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, can include Acute Hospital and/or Physician (Profee) claims
    • Experience with Claims and Denial Que's
    • Familiar with Commercial and Medicaid 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 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

    Numbers & Facts

    LocationCA

    Skills

    • Acute Careunmatched
    • Administrative Skillsunmatched
    • Billingunmatched
    • Claims Processingunmatched
    • Coachingunmatched
    • Content Management Systems (CMS)unmatched
    • Corporate Policiesunmatched
    • Credit and Collectionsunmatched
    • Customer Support/Serviceunmatched
    • Data Collectionunmatched
    • Data Entryunmatched
    • Detail Orientedunmatched
    • Disciplinary Actionunmatched
    • Follow Throughunmatched
    • Hospitalunmatched
    • Information/Data Security (InfoSec)unmatched
    • Insurance Claimsunmatched
    • Maintain Complianceunmatched
    • Medicaidunmatched
    • Medical Billingunmatched
    • Multitaskingunmatched
    • Organizational Skillsunmatched
    • Past Due Accountsunmatched
    • People Managementunmatched
    • Problem Solving Skillsunmatched
    • Procedure Developmentunmatched
    • Procedure Implementationunmatched
    • Quality Assuranceunmatched
    • Quality Managementunmatched
    • Quality Metricsunmatched
    • Third-Party Payerunmatched
    • Time Managementunmatched
    • Training/Teachingunmatched
    • Work From Homeunmatched

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