Offer summary

Qualifications:

2 years of recent Critical Access and Rural Health Clinic billing experience., 2+ years of Epic HB billing experience., Medicaid billing experience is required., Strong written and verbal communication skills, along with computer proficiency. .

Key responsabilities:

Prepare and submit claims to third-party insurance carriers, ensuring accuracy and compliance.

Follow up on unpaid claims and manage rejections by correcting errors and resubmitting as needed.

Maintain quality customer service and confidentiality while processing paperwork and responding to inquiries.

Collaborate with the Billing Manager/Supervisor to resolve reimbursement issues and review billing reports.

Job description

The Billing and Posting Resolution Provider is responsible for providing TruBridge services to customers. This includes coordinating the day to day activities of a hospital's or clinic’s business office such as patient billing and collection, third-party payer relations, and/or preparation of insurance claims.

CPSI’s Brand Values are the driving force behind our company, our interactions with customers and our interactions with each other.

Essential Functions:

In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing.
Secures needed medical documentation required or requested by third party insurances.
Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers.
Responsible for consistently meeting production and quality assurance standards.
Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer.
Updates job knowledge by participating in company offered education opportunities.
Protects customer information by keeping all information confidential.
Processes miscellaneous paperwork.
Ability to work with high profile customers with difficult processes.
May regularly be asked to help with team projects.
Ensure all claims are submitted daily with a goal of zero errors.
Timely follow up on insurance claim status.
Reading and interpreting an EOB (Explanation of Benefits).
Respond to inquiries by insurance companies.
Denial Management.
Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles.
Review late charge reports and file corrected claims or write off charges as per client policy.
Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy.
Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer.

Minimum Requirements:

Education/Experience/Certification Requirements

2 years of recent Critical Access and Rural Health Clinic billing.
2+ years of Epic HB billing
Medicaid Billing Experience Required.
Computer skills.
Experience in CPT and ICD-10 coding.
Familiarity with medical terminology.
Ability to communicate with various insurance payers.
Experience in filing claim appeals with insurance companies to ensure maximum reimbursement.
Responsible use of confidential information.
Strong written and verbal skills.
Ability to multi-task.

Business Support

Required profile