Hospital Biller I

Title: Hospital Biller 1

Location: Remote

Job Description:

Full time

job requisition id

REQ4106

Base Pay Range:

$20.43 - $30.65

in the team that delivers a Healthier Bottom Line. Our purpose at InlandRCM is to strengthen rural hospitals by providing dependable, all-American revenue cycle expertise that sustains access to quality healthcare in rural communities.

The Hospital Biller I is a Full Time, Regular position working in several hospital client EMRs such as Epic, Cerner and Meditech Expanse. Hands-on experience in at least one of these hospital EMRs is required, with experience in multiple systems preferred but not required. This position is remote Monday-Friday day shift 8am-5pm PST. This role requires the ability to work efficiently within the EMR to review claim and patient information, identify and resolve claim edits and denials, and follow up directly with insurance payers as needed, while managing work across multiple client accounts in a typical day. Detailed billing and denial scenarios will be discussed during interviews to confirm hands-on practical experience working directly in Epic, Cerner or Meditech Expanse.

Summary:  Address large volume of unpaid or incorrectly paid/denied claims to secure reimbursement. 

General Description:  Performs medical billing functions as related to both institutional and professional claims. Reviews and resolves claim edits and rejections and resubmits clean claims. Reviews unpaid claims, including denials, and appropriately resolves and resubmits adjusted/corrected claims. Researches and/or resolves overpayments/credit balances. 

Essential Duties/Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

·          Responsible for all phases of billing to government and commercial insurers, including initial billing of clean claims electronically or on paper, subsequent follow up on unpaid claims to the point of payment or resolution of the claim, and resolving credit balances.       

·          Prioritizes assigned worklist of aged accounts appropriately and works on aging accounts to their resolution.

• Reviews and processes electronic claims, claim edits and deletions appropriately and compliantly.

• Interprets billing regulations accurately and within federal, state, and third-party billing regulations and policies.

• Utilizes various client host systems in order to research and rebill claims.

• Other special projects and duties as assigned.

General Duties and Responsibilities:

·          Ability to maintain strict confidentiality within the Inland Imaging companies and Inland’s customers.

·          Follows all Health and Safety policies and guidelines of Inland Imaging or its partners depending on work location.

• Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.

• Follows all policies regarding HIPAA, non-disclosure of confidential information and company security.

·          Honest, pleasant manner and good personal hygiene.

·          Free of alcohol and drug abuse.

·          Valid state driver’s license and proof of insurance.

·          Excellent communication and interpersonal skills.

·          Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.

·          Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.

·          Ability to consider individual needs in communication with and assessment and treatment of patients of all ages.

·          Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.

·          Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.

·          Performs other duties as required by displaying team spirit and self-growth, accepting, and performing other projects and responsibilities, and requesting other projects and responsibilities.

·          Quarterly quality assurance meeting attendance is required for this position.

·          Attendance is a requirement for this position.

·          Rotates to other shifts and locations as needed.

·          Performs other special projects and duties as assigned.

Supervisory Responsibilities:

·          There is little or no supervisory responsibility in this position

 

Advocacy:

• Treats all clients with dignity and respect

• Provides excellent customer service

• Conforms to Joint Commission and HIPAA regulations

• Complies with PHI (Protected Health Information)

• Demonstrates the Inland Imaging Core Values:

  • Show We Care, Do The Right Thing, Maximize Individual Potential, Always Aim Higher

Qualifications:  

·          Education: High School Diploma/GED required.

o   Two-year medical billing course successful completion is desired.

·          Experience: At least one year of experience in billing medical claims to either government or commercial insurers.  At least one-year prior experience in Epic billing software. Preferably has experience in hospital billing, but will accept equivalent in physician, clinic, or ASC billing.

o   Working knowledge of government hospital payment methodologies including OPPS, Critical Access Hospital method II, or both preferred.

o   CPT, HCPCs and ICD-10 coding experience preferred.

o   Experience with electronic claims scrubbing and clearinghouse systems preferred.

·          Licensure:   N/A

·          Certifications preferred:  One certification from an industry recognized healthcare accrediting body at the start of the job or obtain it within 6 months of starting job.

·          Computer Skills: Experience with Epic software required. Experience with the following computer applications is highly desired: Microsoft Office products (Outlook, Word, Excel), Internet, Intranet, Meditech or other hospital or physician EHR/accounting system.

·          Remote Work Capability. Ability to work from a remote (home) based environment if requested.  Need to have a dedicated workspace with desk, desk chair, and access to cable internet.

·          Background Check:

o   Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults

o   In order to comply with provisions set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of Inland Imaging Business Associates will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG).  Employees must not be included on this list.  

·          Drug Test: Eligible employees must be able to pass a post-offer, pre-employment drug test.

Summary:  Address large volume of unpaid or incorrectly paid/denied claims to secure reimbursement.

General Description:  Performs medical billing functions as related to both Institutional and Professional claims. Reviews and resolves claim edits and rejections and resubmits clean claims. Reviews unpaid claims, including denials, and appropriately resolves and resubmits adjusted/corrected claims. 

Essential Duties/Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Responsible for all phases of billing to government and commercial insurers, including initial billing of clean claims electronically or on paper, subsequent follow up on unpaid claims to the point of payment or resolution of the claim, and resolving credit balances.    
• Prioritizes assigned worklist of aged accounts appropriately and works on aging accounts to their resolution.
• Reviews and processes electronic claims, claim edits and deletions appropriately and compliantly.
• Interprets billing regulations accurately and within federal, state and third party billing regulations and policies.
• Utilizes various client host systems in order to research and rebill claims
• Other special projects and duties as assigned.

General Duties/Responsibilities:

• Ability to maintain strict confidentiality within the Inland Imaging companies and Inland’s customers.
• Honest, pleasant manner and good personal hygiene.
• Free of alcohol and drug abuse.
• Valid state driver’s license and proof of insurance.
• Excellent communication and interpersonal skills.
• Detail oriented; ability to multi-task; organized and able to work in a fast paced environment.
• Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.
• Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
• Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.
• Follows all Health and Safety policies and guidelines of Inland Imaging and its partners depending on work location
• Performs other duties as required by displaying team spirit and self-growth, accepting and performing other projects and responsibilities, and requesting other projects and responsibilities.
• Attendance is required for this position.
• Rotates to other shifts and locations as needed.

Supervisory Responsibilities:

• There is little or no supervisory responsibility in this position

Advocacy:

Treats all clients with dignity and respect Provides excellent customer service Conforms to Joint Commission and HIPAA regulations Complies with PHI (Protected Health Information) Demonstrates the Inland Imaging Core Values:

• Show We Care, Do The Right Thing, Maximize Individual Potential, Always Aim Higher

Qualifications:  

• Education: High School Diploma/GED required
  • Two year medical billing course is desired
• Experience: At  least 2 years of experience in billing requirements for either government or commercial insurers, preferably experience in hospital billing, but will accept equivalent in physician billing
  • Working knowledge of government hospital payment methodologies including OPPS, Critical Access Hospital method II, or both preferred
  • CPT, HCPCs and ICD-10 coding experience preferred
  • Experience with electronic claims scrubbing and clearinghouse systems preferred
• Licensure:   N/A
• Certifications:  N/A
• Computer Skills:  Experience with the following computer applications is highly desired: Microsoft Office products (Outlook, Word, Excel), Kronos; Replicon; Internet, Intranet, Meditech, Healthland, Techtime, EMDs, Epic or other hospital or physician accounting system.
• Background Check:
  • Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults
  • In order to comply with provisions set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of Inland Imaging Business Associates will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG).  Employees must not be included on this list.  
• Drug Test: Eligible employees must be able to pass a post-offer, pre-employment drug test which includes marijuana.

Nuvodia/Inland is an EEO employer...