Senior Biller: Monday through Friday - 3 month assignment
JOB SUMMARY:
This is an experienced Senior Biller responsible for preparation, editing and submission of accurate and timely insurance claims (electronic and manual) to third-party payers. Claims process includes reconciling claim runs, creating electronic claim files, and resolving errors. Resolve claims editing issues and interact with third party clearinghouse or the claims scrubber vendor to produce clean claims. Conducts research / analyze coding errors, document billing issues / trends, and assist with problem solving and solutions. This role will be responsible for coaching /mentoring new billing staff.
Stay informed of new and/or changing regulations as well as payer policy time limits, and incorporates updates into daily operations. May be required to participate in internal and external audits, review audit findings and implements changes as required. Resolves issues holding up timely claim payment, including requests for medical records, coordination with Customer Service and other related departments.
Participates in the design of systems to support the business and operational needs of Swedish Medical Center. Collects and documents business requirements, and assists in the development of new workflows, policies and procedures, and documentation for the department.
QUALIFICATIONS
The minimum qualifications listed below are representative of the knowledge, skill and abilities needed to perform this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.
Education:
Bachelor degree in Finance, Business Management or health care administration preferred. Medical terminology and medical coding training in an accredited school or equivalent on-the-job training in a billing role required.
Licensures/Certifications:
None
Experience and Skills:
Two years experience in hospital insurance billing, including Medicare and Medicaid and private insurance billing experience required. A strong technical background including experience with automated systems preferred; proficient in working with Epic highly desirable. Knowledge of the revenue cycle and/or regulatory requirements as they relate to the hospital and professional billing and collections for third party insurance payers required. Detailed knowledge and understanding of ICD-9, CPT, and HCPCS coding classification systems, familiar with medical terminology and its applications, insurance rules and regulations.
Knowledge of state and federal regulations as they pertain to billing processes and procedures.
Knowledge of insurance claim processing and third party reimbursement.
Knowledge and detailed understanding of all negotiated agreements.
Skill in good oral, written, and interpersonal communication.
Skill in problem solving in a variety of settings.
Ability to work efficiently under pressure.
Ability to work independently and take initiative.
Ability to demonstrate a commitment to continuous learning and to operationalize that learning.
Ability to deal effectively with constant changes and be a change agent.
Ability to deal effectively with difficult people and/or difficult situations.
Ability to willingly accept responsibility and/or share responsibility.
Ability to set priorities and use good judgment for self.
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