Business Office-Billing & Collection Specialist - Full Time

Business Office-Billing & Collection Specialist - Full Time

POSITION SUMMARY:

To effectively provide billing and collection resources to the organization. To ensure the appropriate billing and collection of all claims the management of accounts receivable and all other aspects of the organization revenue cycle.

POSITION REQUIREMENTS:

Minimum Education:

• High School Diploma or equivalent.

Work Experience Required:

• Must be proficient with Microsoft Office Suite, PowerPoint, Excel, and Word, and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

Minimum Work Experience Preferred:

• Knowledge of EPIC EHR is desirable. 
• Knowledge of CMS 1500/UB billing preferred.
• Knowledge of the physician practice and hospital revenue cycle preferred.
• Knowledge of multiple insurance billing requirements preferred.
• 1-2 years of billing experience in NV Medicaid, Commercial and Managed Care billing preferred.
• Billing and Collection experience preferred.
• Knowledge of UB04 Inpatient and Outpatient Medicaid Billing in a Hospital or Healthcare setting preferred.

POSITION ESSENTIAL FUNCTIONS:

Billing 

• Works with team to ensure the accurate entry of charge data to include appropriate CPT and CD - 9/10 codes.
• Works with physicians and other staff to ensure all encounter forms are completed at time of service and coding is accurate and representative of the patient visit.
• Accurately sends out bills to third party payers (electronically and via paper) daily.
• Ensures all electronic claims have been received on a daily basis.
• Work assigned Work Queues to correct errors, ensuring accurate claims and reimbursement on first claim submission.
• Audit denials and payment variances to determine root cause and correction as required.
• Auditing payment variances ensuring appropriate reimbursement.
• Provide specific and in depth contract knowledge to ensure maximum reimbursement of healthcare claims.
• Resolve credit balances by reviewing payments, adjustments or transfers correcting the patient account to reflect an accurate account receivable balance.
• Work with leadership and other internal departments to improve processes, increase accuracy, create efficiencies and decrease denials to achieve the overall goals of the organization.
• Maintain a current knowledge of CPT/HCPCS, CD, DRG, HCFA forms, ability to manipulate and analyze 837 and all other HIPAA transaction sets.

Collections

• Accurately track and follow up on all outstanding claims from the third party providers.
• Utilize telephone and computer methods to track the status of each claim.
• Maintain a portfolio of claims that are followed up each month.
• Review Explanation of Benefits on a regular basis to identify denial trends.
• Adequately prepare denial reports and train physicians and staff on how to prevent denials through accurate coding.
• Contact all patients regarding outstanding balances.
• Work with outsourced collection agencies.

Communication

• Answers telephones, routes callers, takes messages and provides routine information to callers.
• Returns Phone calls in a timely manner.
• Relays messages to appropriate staff members.

BENEFITS: If you are scheduled to work part-time at least 20 hours per week and full-time at least 32 hours per week, you are eligible for benefits on the first day of the month following 30 days of employment.

• NO STATE INCOME TAX
• Hometown Health Medical, EyeMed Vision, Guardian Dental and Flexible Spending Account.
• Vanguard 401(k) with match.
• Employer paid Care Flight Membership for your household (full-time employees) (A Division of REMSA).
• Employer Paid Basic Life and AD&D insurance.
• Unum Supplemental Insurance (Critical Illness, Accident, Short Term & Long Term Disability).
• Earned Time Off, Sick Leave and Paid Holidays.
• Nevada 529 College Fund.
• Unum Employee Assistance Program.
• Employer paid Credit monitoring and Identity Theft Program through CyberScout.
• Tuition Reimbursement, Clinical Ladder* & HRSA Loan Repayment Program* (*for qualifying positions).
• Priority Childcare Enrollment with the Boys and Girls Club of Western NV for ages 9 months .
• Paid Volunteer Hours for staff to help in the community.
• and More...

CARSON VALLEY HEALTH IS PROUD TO BE RECOGNIZED AS A FINALIST IN THE

"BEST PLACES TO WORK" - NORTHERN NEVADA, 2021, 2022 & 2024!

WE LOOK FORWARD TO WELCOMING YOU TO OUR TEAM!!