计费员 - 索赔与拒付 - 全流程计费员
Biller - Claims & Denials - Full-Cycle Biller
全周期账单专员负责为新罕布什尔州的急诊医院（UB-04）和农村健康诊所（CMS-1500）提供TruBridge索赔处理服务。这包括协调医院或诊所业务办公室的日常活动，如患者账单和收款、第三方保险公司关系，以及保险索赔的准备。
核心职责：除按照我们的绩效指标执行工作外，该职位的具体职责包括：
- 协调业务办公室的功能和人员，可能包括但不限于患者账单、信用和收款以及数据录入。
- 建议新的流程并改进现有流程。
- 实施控制措施，确保按照既定程序进行适当的提交、账单处理及信用和收款。
- 为第三方审批、账单处理和逾期账户的收款制定适当的跟进程序。
- 确保员工按照既定程序和第三方要求进行准确及时的账单处理。
- 负责持续满足生产率和质量保证标准。
- 通过遵循公司政策和程序以及每个客户的特定政策和程序，保持高质量的客户服务。
- 通过参与公司提供的教育机会来更新岗位知识。
- 通过保密所有信息来保护客户信息。
- 处理各种文件。
- 能够与高知名度客户合作，处理复杂流程。
- 可能经常被要求协助团队项目。
- 负责协助经理管理员工，包括指导、培训以及必要的纪律处分，包括跟进员工的行动计划。
- 通过遵循公司政策和程序以及每个客户的特定政策和程序，保持高质量的客户服务。
- 确保员工遵守着装规范、出勤和其他公司政策。
- 处理各种文件并执行分配的其他行政任务。
最低要求：
教育/经验/认证要求
- 至少3-5年的全周期账单经验，可以包括急性医院和/或医生（Profee）索赔
- 具有索赔和拒付队列的经验
- 熟悉商业和医疗补助计划
查看英文原文
The Full-Cycle Biller is responsible for providing TruBridge claims processing services to Critical Access Hospital (UB-04) and Rural Health Clinic (CMS-1500) facilities in New Hampshire. 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.
Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
- Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry.
- Recommends new processes and changes in current processes.
- Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures
- Implements appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts
- Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third-party requirements
- 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
- Responsible for assisting manager in the management of employees which would include coaching, training and performing necessary disciplinary actions including following up on action plans for their employees.
- Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
- Ensures employee compliance with dress code, attendance and other company policies.
- Processes miscellaneous paperwork and performs other administrative duties as assigned.
Minimum Requirements:
Education/Experience/Certification Requirements
- At least 3-5 years Full-Cycle billing experience, can include Acute Hospital and/or Physician (Profee) claims
- Experience with Claims and Denial Que's
- Familiar with Commercial and Medicaid claims REQUIRED
- Strong organizational, multi-tasking, and time-management skills.
- Must be detail oriented and able to follow through on issues to resolution.
- Must be able to act both independently and as a team member.
- High School Diploma or equivalent combination of education and relevant experience needed.
- Excellent critical thinking, organizational, and time management sills with a strong attention to detail, accuracy, and follow through
Why join our team?
- Work remotely with a work/life balance approach
- Robust benefits offering, including 401(k)
- Generous time off allotments
- 10 paid holidays annually
- Employer-paid short term disability and life insurance
- Paid Parental Leave
Originally posted on Himalayas