CMS-1500

claim forms. Knowledge of CPT, ICD-IO-CM, and HCPCS coding principles (basic understanding). Experience with hospital billing systems and electronic health records (EHR). Work Environment Training in office is required. Once trained there are a variety of options depending on skill, training and hospital requirements: in office, at home or hybrid (mix of in office and home). May require occasional overtime to meet billing deadlines. Responsibilities Billing Operations

Prepare, review, and submit electronic and paper claims to insurance carriers and government payers depending on assigned team. Ensure claims are compliant with CMS, Medicare, Medicaid, and commercial payer guidelines as appropriate for team. Monitor claim status and resolve claim edits, rejections, and denials in a timely manner. Submit corrected claims and appeals as needed. Account Management
Follow up on unpaid, underpaid, or denied claims as assigned. Research and resolve billing discrepancies. Prepare and submit appeals with appropriate documentation. Document all actions and activities taken in the billing system. Maintain productivity and quality benchmarks. Timely and accurate management of all assigned work Queues. Customer Service
Respond to insurance inquiries regarding claim processing/issues. Provide clear, professional communication to all customers while maintaining patient confidentiality. Provide accurate, timely feedback to Patient Account Resolution staff regarding patient inquiries. Compliance
Adhere to HIPAA regulations and hospital policies. Maintain confidentiality of protected health information (PHI). Stay current on payer updates, state and federal billing regulations, and reimbursement procedures. Teamwork
Collaborate with team members on a daily basis by sharing information and assistance as needed. Assists with team members' responsibilities in their absence. Works cooperatively to resolve billing issues with other teams including but not limited to: Provider Offices, Patient Account Resolution, Hospital Departments and Registration. Technology
Up to date knowledge of systems used by PFS to include but not limited to: Cerner, payer websites, Availity, MMIS, Connex, FISS, FinThrive, Policy Tech and Microsoft Office Products as applicable.

Concord Hospital is an Equal Employment Opportunity employer. It is our policy to provide equal opportunity to all employees and applicants and to prohibit any discrimination because of race, color, religion, sex, sexual orientation, gender, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status.

Know Your Rights:

Workplace Discrimination is Illegal Applicants to and employees of this company are protected under federal law from discrimination on several bases. Follow the link above to find out more. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, you may contact Human Resources at 603-230-7269. Physical and Work Requirements The physical demands and characteristics of the work environment described here are representative of those that will be encountered by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The Dictionary of Occupational Titles Material Handling Classification is

SEDENTARY.

The employee must regularly lift, carry or push/pull less than 10 pounds, frequently lift, carry or push/pull less than 10 pounds, and occasionally lift, carry or push/pull up to 10 pounds. While performing the duties of this Job, the employee is regularly required to do repetitive motion, hear, and sit. The employee is frequently required to do fine motor, reach, and speak. Specific vision abilities required by this job include far vision, and near vision. The employee is occasionally exposed to moving mechanical parts. The noise level in the work environment is usually moderate. Concord Hospital (CH) is a nationally-accredited, progressive regional health system. Over the past two decades, CH has evolved from a community hospital to a $550 million net revenue regional integrated health system with more than 3,574 employees, leaders and clinicians who are talented, mutually supportive, and community centered in helping the organization meet its community mission. CH has sophisticated clinical and management practices. The organization consistently performs among the top ten percent of national organizations and has received many national accolades (e.g., most wired, Press Ganey's summit award). After a four-year effort to strengthen and standardize our quality management processes, Concord Hospital has become the first healthcare system in New Hampshire to be certified as being in compliance with internationally recognized quality management practices

ISO 9001

2008 certification, issued by

DNV GL. ISO

certification means that patients can be confident CH has implemented and strengthened processes for internal auditing, control of documents, control of records, control of non conforming products, and preventative and corrective action. 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