Patient Billing Rep

Position: Patient Billing Rep I
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. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s 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.
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* Job Summary:

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* Location:

Methodist Corporate Office  Address: 825 S 169th St.

- Omaha, NE

Work Schedule:

Mon - Fri, 8-hour shifts, time is flexible between 6:00am and 6:00pm    Responsible for billing, electronic claims submission, follow up and collections of patient accounts.
** Responsibilities:
**** Essential Functions
** Electronic and Hardcopy Billing
* All EDI and paper claims submitted are to be billed as needed following department and payer specific guidelines.
* Obtains appropriate EOB's through use of health system resources.
* Reviews Billing Scrubber Claim Detail Screens to ensure data is appropriate for claim submission.
* Ensure that claim corrections identified in billing scrubber are appropriately updated and documented in Source System.
* Prepares secondary and tertiary billings, manually and electronically on UB04's and/or 1500's for accurate reimbursement.
* Submits adjusted UB04/837I and/or CMS
1500/837P claims according to department and payer specific guidelines.

Display Effective Communication Skills
* Demonstrates active listening skills.
* Notifies and keeps leads and supervisors informed on issues identified.
* Follows telephone etiquette procedures set forth by the organization and/or individual department.
* Professional/Courteous responses when communicating with customers, health system staff and management.

Handling of Referrals
* Timely and accurately handling of referrals, both regular and escalated priority from management, within department guidelines.
* Documents clearly and appropriately all referrals (including patient inquiries) in the Source System when necessary.
* If necessary, follows up with patients on final results of inquiry both timely and professionally.  Notifies patient of final results of account handling in question.

Knowledge of System Applications
* Demonstrates ability to learn and maintain a working knowledge on all the current health system applications.
* Identify/obtain/print medical records as necessary for resolution of denial or system edits according to department guidelines.

Auditing of Patient Accounts
* Understand accounting and business principles to accurately determine the remaining balance on a given encounter.
* Upon accurately auditing encounter or visit, is able to understand and update proration to make sure dollars are allocated to the appropriate benefit orders if needed.
* Leverages all needed resources to complete an audit of an account.
* Documents audit finding and actions taken in Source System when necessary.

Claim Follow Up with Third Party Payers
* Full understanding of all necessary third party billing and follow up processes based on department specifications.
* Full understanding of all necessary contract related requirements.
* Leverages payer websites and necessary tools to streamline the follow up process.
* Appropriate documentation in Source System when necessary.
* Ability to interpret correspondence assigned for accurate handling.

Special Projects and Tasks as Assigned
* Completion of any assigned projects timely, accurately and to the specifications of leadership.
* Ensure Daily/Weekly/Monthly assignments are handled accurately and timely.

Maintaining Daily Workflow
* Manages and maintains assigned workflow queues according to department guidelines.
* Mail/Correspondence processed and handled following departmental guidelines.
* Documents both timely and appropriately in Source System using proper documentation methods.
* Fundamental understanding…