Business Office: Billing and Claims Specialist

Schedule:

This is a full-time position, Monday-Friday, 8:00 a.m. to 4:30 p.m.

Reports To:

Business Office Manager/CFO Job Summary of Business Office:

Billing and Claims Specialist:

Responsible for compiling itemized hospital bills, verifying patient insurance coverage, and computing patient insurance benefits. Works closely with the Admitting Office, Medical Records and physicians' office staff. Demonstrates Competency in the

Following Areas:

Verifies hospital insurance information. Compiles hospital bills, completes appropriate forms, submits claims to proper agencies/insurance companies. Contacts patients/insurance companies to collect unpaid insurance claims. Stays informed about changes in Medicare and Medicaid. Maintains current patient accounts and addresses in the computer system to avoid loss of claims. Always verifies patient account number. Maintains a computer master list of insurance companies outlining correct name and address. Answers the telephone in a polite manner. Communicates information to the appropriate personnel. Demonstrates the ability to be flexible, organized and function well in stressful situations. Interacts with patients/families in a professional manner. Provides explanations regarding statements, insurance coverage. Treats patients/families with respect; ensures confidentiality of patient records. Maintains a good working relationship within the department and with other departments. Maintains a professional working relationship with insurance companies. Performs other duties as assigned. Ensures documentation meets current standards and policies. Posts cash and insurance payments daily. Investigates and appeals denied claims when necessary.

Professional Requirements:

Adheres to the dress code; appearance is neat and clean. Completes annual educational requirements. Maintains regulatory requirements. Reports to work on time and as scheduled; completes work within designated time. Wears identification while on duty; uses computerized punch time system correctly. Attends staff meetings; reads and returns all monthly staff minutes. Participates in CQI activities. Able to work independently. Strong attention to detail.

Regulatory Requirements:

High school graduate or equivalent.

Language Skills:

Ability to communicate in English, both verbally and in writing. Other languages preferred.

Skills:

Thorough understanding of Medicare, Medicaid, HMO's, PPO's, private insurance companies. Basic computer knowledge, data entry skills. Hospital billing experience preferred. Healthcare terminology preferred. This institution is an equal opportunity provider and employer.

Job Type:

Full-time Expected hours: 40 per week

Benefits:

401(k) Dental insurance Employee assistance program Flexible spending account Health insurance Health savings account Life insurance Paid time off Referral program Retirement plan Tuition reimbursement Vision insurance Ability to

Commute:

Neligh, NE 68756 (Required) Ability to

Relocate:

Neligh, NE 68756: Relocate before starting work (Required)

Work Location:

In person