Senior Technical Application Consultant - Medical Professional Billing, Kaiser Permanente - Pasadena, CA

Senior Technical Application Consultant - Medical Professional Billing, Kaiser Permanente - Pasadena, CA

Description
Kaiser Permanente HealthConnect is an integrated clinical and administrative information management system that integrates the patient's electronic medical record with their appointments, registration and billing information. The system links KP departments and facilities nationwide, providing KP physicians and care teams access to current and comprehensive patient information and providing KP members 24/7 on-line access to key portions of their medical record. Enhancing patient safety and care quality, the impact and benefits of KP HealthConnect are expected to be felt throughout all of KP and to set new standards for the health care industry as a whole.
We currently have a need for a Senior Application Coordinator in support of our professional billing software (specifically Resolute, Epic's product for billing).  As a Senior Application Coordinator you will be responsible for achieving an in-depth knowledge of the Resolute software to provide second level support to the entire revenue cycle.

Basic Qualifications

• Bachelor's degree, or 4 years of additional related work experience.
• Minimum of 2 years of recent experience with Professional Billing, specifically with Epic Resolute.
• EPIC Certification in Professional Billing and/or Professional Claims.
• IT experience with maintenance of masterfiles (database managers or data directories), interfaces, and workflows.
• Application implementation, installation, and maintenance experience.
• Strong analytical skills and problem resolution capabilities.
• Strong communication skills.
• Ability to function independently with minimal oversight and direction.
• Ability to work Monday through Friday, 40+ hours a week, but flexible as needed for implementation/upgrade needs.

Preferred Qualifications

• Detailed experience and knowledge of one or more of the following Epic Resolute areas is strongly preferred: electronic claims, electronic remittances, and work queue rule creation.
• Ansi X12 835 and 837 experience
• Knowledge of KP standard systems interface technologies and protocols, including HL7 and batch interfaces, Revenue Cycle

Billing Representative, Tuality Healthcare - Hillsboro, OR

Billing Representative, Tuality Healthcare - Hillsboro, OR

Summary of Duties
Posts payments and other information gathered from insurance explanation of benefit forms, in the computerized practice management system.Reconciles daily batch posting to source documents.Analyzes patient accounts and performs secondary insurance billing.Places phone calls to guarantors and insurance carriers requesting payment of past due funds.Responds to requests for information from insurance carriers and patients and performs clerical and bookkeeping duties requiring a considerable degree of judgment and decision-making.

Requirements

• Education: Prefer high school graduate or GED. Prefer bookkeeping class completion or equivalent experience.
• CREDIT CHECK REQUIRED – Any job offer for this position is contingent upon review of candidate’s credit history.
• Knowledge of CPT & ICD-9 CM coding systems.
• Typing 40 WPM preferred.
• 10-key by touch preferred.
• Knowledge of medical terminology preferred.
• Must have good telephone skills.
• Problem solving and planning skills required.
• Understands and follows written and oral instructions.
• Must be task oriented, as position requires attention to detail.
• Previous medial insurance billing experienced preferred.
• Knowledge of Medicare, Medicaid, MVA, Workers’ comp and HMO insurance plans preferred.
• Uses effective communication skills.
• Personal appearance makes a goof first impression.

Associate Billing, Alexian Brothers Health System - Arlington Heights, IL

Associate Billing, Alexian Brothers Health System - Arlington Heights, IL

Position Summary
The Associate is primarily responsible for billing of insurance accounts in accordance with established protocols and procedures, in keeping with established performance measurement standards.

Minimum Qualifications

• Education, Experience and Professional Licensure: High School diploma is required and minimum of one year of business office experience in a hospital, health insurance or other medical setting.
• Knowledge, Skills and Abilities: Sound overall knowledge of hospital billing and collections and the ability to perform the essential functions of the job and to meet its technical requirements, such as: proficiency with Microsoft Office suite, good written and oral communication skills, good interpersonal skills, good problem solving skills, good judgment, flexibility, adaptability and the ability to work in fast paced, pressure situations.

Patient Account Representative, Gateway Medical Center - Clarksville, TN

Patient Account Representative, Gateway Medical Center - Clarksville, TN

Description
The Patient Account Representative supports the reduction of Accounts Receivables by reviewing open accounts, and obtaining payment status via payer websites or by contacting payers by phone.  The Representative performs a variety of duties inlcuidng correspondence response, rebilling, certain denial issues and daily reconciliation of activities.  The Representative meets established productivity and quality guidelines to ensure timely and accurate reimbrusement for all billed charges.  The Representative is responsible for reducing AR againg within assigned payer and assigned section of the AR.  This position is responsible for making certain that the hospital receives all monies due in a timely manner.

Qualifications

• EDUCATION: High School Diploma/ GED
• EXPERIENCE: 1 year experience in healthcare patient financial services; 3 years medical healthcare business office admission, billing and collection preferred. Proficiency and use of computers, printers, faxes, software (Microsoft Office), scanner. 

Billing Clerk, Albert Einstein Healthcare Network - Philadelphia, PA

Billing Clerk, Albert Einstein Healthcare Network - Philadelphia, PA

Albert Einstein Healthcare Network is a private, not-for-profit organization and provides advanced, comprehensive, integrated quality medical services in the greater Philadelphia region and opportune markets. Our network comprises multiple operating divisions offering services including acute/level I trauma, skilled nursing, long-term, rehabilitation and behavioral healthcare. Facilities include the Albert Einstein Medical Center, Belmont Center for Behavioral Health, Einstein Center One, Germantown Community Health Services, Willow Terrace, Willowcrest, and MossRehab.
Albert Einstein Healthcare has an excellent opportunity available for a healthcare billing professional at our Front and Olney facility.

The responsibilities of this position include

• Post payments received from patients and/or insurance carriers.
• Analyze and document rejections received from insurance carriers and update the account accordingly.
• Post write-offs and adjustments according to contracts, policies and procedures.
• Contact insurance carriers and AEMC departments to rectify patients’ account and ensure proper payments are received.
• Reconcile month end payments posted. Submit HCFA claims to insurance carriers.

If you possess the following, please apply

• High school graduate or equivalent required.
• Experience in all aspects of 3rd party physician billing is required. Including but not limited to charge entry, claims processing, payment posting, and the appeal/resubmission process for rejections and follow-up required.
• Strong computer and Internet skills are required.
• IDX software experience is preferred.
• Excellent organizational skills required.

Medical Biller, Resource Management - Salt Lake City, UT

Medical Biller, Resource Management - Salt Lake City, UT

Description

• Seeking a motivated individual with three to five years of medical billing experience.
• Must be experienced with insurance processing and have professional phone and communication skills.
• Must have excellent attention to detail and be able to multi-task.
• Excellent computer skills required; Centricity experience a plus.
• This is a fun and dynamic work environment!
• Full-time with flexible hours!
• This company is a non-smoking employer.

Clinic Office Billing Coordinator, Columbia St. Mary’s - United States

Clinic Office Billing Coordinator, Columbia St. Mary’s - United States

Position Purpose
Coordinates and assists with the daily operational and financial tasks, supervising front office/billing staff, and patient information activities to ensure a positive patient experience and staff satisfaction.

Responsibilities

• Maintains personal skill set, certifications, and competencies to perform applicable staff functions within the clinic.
• Coordinates staff to ensure smooth flow of operations.
• Effectively coordinates Human Resources related functions.
• Manages the patient experience to ensure a high level of safety and service.
• Ensures compliance and completion of appropriate documentation required by regulatory agencies and CSM quality initiatives.
• Demonstrates fiscal responsibility and stewardship over assets assigned.
• Effectively coordinates Information Services (IS) as it relates to the practice management and EMR operations of the clinic.

Qualifications

• Bachelors of Science in Health Administration or Business
• 3 years of medical/clinic experience
• 2 years front office/provider based billing experience
• Cardiology experience preferred
• Experience with Physician recruitment/relations

Claims Processor, Penmac - Springfield, MO

Claims Processor, Penmac - Springfield, MO

Job Details

• Springfield insurance claims processing company needs a claims processor to work with medical and dental claims.
• Will be doing paperwork related to claims and talking to employees and providers about them.
• Must have good customer service and computer skills.
• Non-Smoker only.
• Medical billing or accounting experience required.

Medical Billing Clerk, Cincinnati, OH

Medical Billing Clerk, Cincinnati, OH
Job Description
Management skills, strong Medicare billing regulations and guidelines knowledge and the ability to present to clients.
Must have a solid background in medical claims for hospitals

Requirement

• 3 plus years of recent healthcare management experience.
• 5+ years Medicare claims experience with much of it for hospital claims.
• Local or regional for an easy move.

Medical Billing Specialist Central Billing Office Slidell Memorial Hospital - Slidell, LA

Medical Billing Specialist Central Billing Office Slidell Memorial Hospital - Slidell, LA

Job Details
The Physician Office Billing/Coding Specialist serves as a vital contact for financial concerns for medical services rendered in the physician office by communicating to patients  and/or insurance companies in a friendly professional manner.  This position requires a very strong emphasis on oral communication, excellent telephone and customer service skills, and a willingness to interact with the public.

• Demonstrates  the ability to organize and plan daily work with completion requirements.
• Maintains the integrity of patients accounts receivables.
• In addition, the job position is responsible for verifying and managing all billable services.
• Accurately and consistently applies SMH Physician Networks denial codes, adjustment codes, and payment codes in patient accounts.  Reviews, corrects, and maintains patient accounts for correct Insurance Group and Insurance Class assignment.
• Responsible for reviewing the patients accounts’ financial activities for accuracy of coding, charge posting, of patient payments, and reviewing daily cash deposits.
• Reviews the patients daily cash collections posted by the Physician Office Check-Out representative for accuracy of collections and posting of insurance co-payments and identifies errors to patient co-pays and deductibles per assigned insurance contracts.
• Documents all communications and correspondence with patients, insurance carriers, medical providers, and vendors.
• Processes batches daily and reviews the batch report on the following day for any charges requiring additional information and correction.
• Reviews and corrects daily pre-bill denials and reprocesses for payments.
• Stays up-to-date with any insurance/payor source requirements and inform staff of any changes.
• Attend insurance/payor source inservices when available.
• Communicates to SMH Physicians Network supervisor any concerns, issues, and/or processes to either improve the quality of care provided or improve the operational efficiency.
• Communicates weekly with Office Managers on charging improvements and/or improve denial management.
• Performs other duties as assigned or directed to ensure smooth operation of the organization.
• Knowledge of CPT/HCPCS coding, billing, reimbursement processes and denial reason codes.
• Capable of making decisions using critical thinking skills.
• High school diploma, GED not acceptable.
• Minimum one (1) year of billing and/or collections experience in a physician office. 

Billing Assistant, Proctor Hospital - Peoria, IL

Billing Assistant, Proctor Hospital - Peoria, IL

Job Details
Provides daily payment posting, deposit preperation and mail processing for the Proctor First Care offices.  Responsible for assisting Patient Accounts Specialist.  Provides insurance followup.

Minimum Requirements

• High school diploma or equivalent.
• Medical billing experience.
• Computer literacy.
• Excellent customer service and phone skills. 

Patient Account Representative - Centralized Account Billing Management, Intermountain Healthcare - West Valley City, UT

Patient Account Representative - Centralized Account Billing Management, Intermountain Healthcare - West Valley City, UT

Description
To provide effective billing, problem solving and maintenance of financial computer records for all patients. Responsible for maintaining patient accounts from billing to collection. The incumbent follows protocol as it pertains to their particular clinic setting.  May also perform duties and functions of a Patient Service Representative.

Qualifications
Minimum Requirements

• At least two years of customer service experience in an office setting is required.
• High school diploma or GED is required.
• Strong computer keyboarding skills are required; Must be able to type at least 30 wpm and know 10 key by touch.
• Demonstrated effective communication and interpersonal relation skills.
• Must have the ability to follow work instructions and procedures.

Preferred Qualifications

• Medical terminology preferred.  IDX experience preferred.
• Medical, insurance, billing, collections, and/or accounting experience are all preferred.
• Current or previous employees of Intermountain Healthcare having worked in an office/clerical role preferred.

Collections Clerk, Alamo City Medical Group - United States

Collections Clerk, Alamo City Medical Group - United States

GENERAL SUMMARY OF DUTIES
Responsible for resolution of A/R in a complete, accurate, and timely manner while verifying that industry rules and regulations, including local, state and federal regulations, regarding billing and collection practices are followed; as well as with established internal policy and procedure.

• KNOWLEDGE: Knowledge of submission and processing of medical claims (HCFA 1500 forms). Knowledge of government, commercial, and workers compensation policies and procedures. Knowledge of ICD-9, CPT and HCPCS coding. Knowledge of HIPAA compliance rules and regulations.
• ABILITIES: Ability to effectively communicate in person and on the phone in an effort to collect all monies due. Ability to read and comprehend simple instructions, short correspondence and memos. Ability to write simple correspondence. Ability to effectively present information to customers, clients and other employees of the organization. Ability to do general mathematics. Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.
• SKILLS: Skill in the operation of billing software and all office equipment. Skill in using Microsoft Office (Outlook, Excel, Word, etc.). Skill in processing claims efficiently and in accordance with established time frames. Solid customer service skills and excellent interpersonal skills. Attention to detail.

Requirements

• EXPERIENCE: Minimum of two years related experience as Claims Processor, Insurance Billing and/or Collections. Coding experience helpful.
• REQUIREMENTS: 50 wpm typing skill preferred.
• EDUCATION: High school diploma or GED and one year certificate from college or technical school; or equivalent combination of education and experience. 

Medical Records Clerk, Alutiiq - Pearl Harbor, HI

Medical Records Clerk, Alutiiq - Pearl Harbor, HI

Duties to include

• BILLING OF THIRD PARTY CLAIMS - Create newly discovered Other Health Insurance (OHI) claims via TPOCS. Utilize the CHCS system to gather information necessary to manually create a Third Party claim. Utilize TPOCS and manually populate the information gathered from CHCS to create a claim. Maintain a log of back bills for new OHI discovery. Generate compile and prepare Uniform Business Office (UBO) reports to be entered in the UBO Metrics and submit to higher authority. Reconcile TPC Program accounts and reporting records. Ensure TPC documents indicating amounts paid or collected equals amounts deposited. Ensure TPC records are reconciled with TPC deposits and reports including DD Form 2570 report. The TPC records shall be reconciled monthly with accounting and finance office records
• POSTING OF PAYMENTS AND DENIALS - Utilize TPOCS to post checks and denials received from the insurance carriers. Research in TPOCS and CHCS for bill control number and other pertinent information before posting is done.
• INSURANCE VERIFICATION - When the patient completes the DD2569 form, contract employee will verify the patient’s insurance coverage through various resources (telephone, websites, etc).
• Obtain (via phone, in-person and/or written correspondence) all relevant information regarding Other Health Insurance (OHI) from active duty dependents, retirees, and retiree family members as they present themselves at the Medical Treatment Facility for care/services and at the Pharmacy for prescription services. Ensure all pertinent data elements on the DD 2569 Other Health Insurance form are accurately completed. Scan DD 2569 into contractor’s database and file original copy into member’s medical record. Utilize the DOD medical systems to perform the OHI data entry function requirement application in the Composite Health Care System (CHCS) in use at the MTF. Contractors may be required to attend staff training related to Other Health Insurance. Support shall include filing, copying and mailing of various documents.

SKILLS AND KNOWLEDGE REQUIRED FOR THE POSITION

• Able to read, write, speak, and understand English; able to communicate in a professional manner (written & oral)
• Experience in high level customer service, medical billing, knowledge of insurance plans and terminology
• Knowledge of correspondence rules and regulations
• Able to interpret and apply regulations and procedures
• Knowledge of communications/graphics/word processing software functions, processes and capabilities
• Knowledge of the OHI data entry function requirement application in the CHCS
• Thorough familiarity with health insurance industry practices
• As a minimum, possess a business-professional level of written correspondence
• Basic knowledge of how to use a personal computer/ laptop
• Shall comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirement
• Able to follow instructions and complete tasks assigned by the OHI Project Manager and Uniform Business Office Manager
• Knowledge of the Defense Enrollment Eligibility Reporting System (DEERS), Composite Health Care System (CHCS/AHLTA)
• General knowledge of Medical Service Accounts, DOD MSA, TPC and TPL processes.
• Microsoft Access and Excel knowledge
• Knowledge of or the ability to learn, utilize and apply, and adhere to guidelines found in the following documents:
• DoD 6010.15-M, Military Treatment Facilities (MTF) UBO Manual, current version
• 32 Code of Federal Regulation (CFR), Part 220
• Third Party Outpatient Collection System (TPOCS) Users Guide, current version

 

Medical Billing Clerk, Cincinnati, OH

Medical Billing Clerk, Cincinnati, OH

Job Description

• Management skills, strong Medicare billing regulations and guidelines knowledge and the ability to present to clients.
• Must have a solid background in medical claims for hospitals

Requirement

• 3 plus years of recent healthcare management experience.
• 5+ years Medicare claims experience with much of it for hospital claims.
• Local or regional for an easy move.

  

Patient Account Specialist, Kaweah Delta Health Care District - Visalia, CA

Patient Account Specialist, Kaweah Delta Health Care District - Visalia, CA

Duties
Maintains complete and full knowledge of payer(s) assigned to ensure compliance of specific guidelines and rules, as well as ensuring the District is being reimbursed by the payer in accordance with governmental or contract terms. Is a resource to Finance division management regarding the assigned payer. Completes billing process. Ensures all charges are accurate and appropriate. Receives all correspondence and inquiries related to patient accounts and payer contract for which they are responsible. Utilizes computer systems and/or billing reports to review all patient registrations or admissions for demographic information, appropriate financial class, insurance company and plan, and charges.

Qualifications

• Minimum high school diploma or equivalent preferred.
• Prior Patient Accounting or admissions experience is required.
• Comparable medical billing education may be considered.

Medical Biller, Houston, TX

Medical Biller,  Houston, TX

A growing medical company is in search of a Workman's Compensation Biller. This position is a non-exempt, full time position. Some overtime may be required depending on work load.
Typical duties include

• Billing payers in accordance with current regulations and meeting timely filing requirements.
• Providing timely follow up on any unpaid accounts to obtain proper payment documents and drafting appeal letters.
• Responding to claim denials, assessing issues and taking actions as required
• Obtaining pre-certification and eligibility verification for Work Comp and commercial Carriers.
• Handling patient calls regarding account information and patient responsibility amounts due.
• Working clearing house claim rejections Comments: Other Skills Needed

1. Knowledge of Labor Codes and fee schedules.
2. Able to back up other business office functions as directed by Director based on department needs.
3. Ability to work independently and with a team.
4. Consolidated billing experience a plus.
5. RealMed and Medinformatix experience a plus.
6. Action oriented individual that is well organized and detail oriented.
7. Communicates with clients, claims adjusters, and attorneys effectively.

BILLING SPECIALIST, Partners Healthcare Systems - Charlestown, MA

BILLING SPECIALIST, Partners Healthcare Systems - Charlestown, MA

Responsibilities

• Responsible for the timely and accurate submission of billed claims for both Inpatient and Outpatient Medicaid.
• Performs all related follow-up and resubmission of claims in accordance with payer specific mandates.
• Analyze and process Medicaid credit balance as necessary for void to Mass Health.
• Work with various site managers and their related staff members in obtaining correct insurance information.
• Interacts with case managers in obtaining information i.e. authorizations/screening numbers for Inpatient claims.
• Utilize all resources available to obtain updated information including telephone inquiries, payer websites and Nehen to verify eligibility and claim status whenever possible.
• Other duties as requested or assigned.

Qualifications

• High school diploma or equivalent required.
• Knowledge of Hospital billing, including interactions with insurance companies to resolve billing and/EOB issues. In addition to, the need for knowledge and experience with UB04.
• Office skills, such as data entry, filing, faxing and ability to work as team member.
• Specific experience with billing Medicaid for facility claims preferred.
• Moderate computer skills such as: Microsoft office, Email, Meditech hospital billing system knowledge a plus. Attention to details is a must. 

Patient Biller III - Patient Financial Services, UCSD Medical Center - San Diego, CA

Patient Biller III - Patient Financial Services, UCSD Medical Center - San Diego, CA

Duties and Responsibilities
The Insurance and Patient Biller is responsible for the full range of third party and patient billing duties. Extensive knowledge of medical insurance and State and Federal rules and regulations related to billing Insurance Claims.

• Extensive knowledge in Insurance claims appeals, and range of knowledge in ICD/9, CPT, HCPCS, coding principles.
• Knowledge in self/pay collections and mandated charity laws.
• Knowledge of medical/surgical terminology. Knowledge of accounting and cash handling principles and various billing documents and claim forms.
• Responsible to work system generated claims, edits, attaches records, operative reports and all system reports.
• Responds to billing inquiries from patients, insurance companies and departments.
• Identifies and resolves issues regarding account adjustments, re-billing insurance, and/or collecting from patients as appropriate.
• Responds to high volume inquiries from patients regarding issues such as general billing questions, resolving patient disputes, explaining patient coverage, etc.

Qualifications

• Minimum three (3) years billing experience in a large, complex healthcare environment. Knowledge of medical insurance and State and Federal rules and regulations related to billing Insurance Claims. Extensive knowledge in Insurance claims appeals, and range of knowledge in ICD/9, CPT, HCPCS coding principles.
• Knowledge in self/pay collections. WPM: 30 10-Key by touch. Must work variable hours based on business needs. Have excellent communication skills with the ability to communicate clearly both verbally and in writing.
• Possess the personal characteristics of professionalism, credibility, commitment to high standards, innovation, discriminating judgment and accountability. Preferred: IDX, Siemens, CPT & ICD9 Medical Coding Knowledge preferred. MS Windows Applications: Excel and Word.
• University of California, San Diego (UCSD) Health System is the only university-based medical facility in San Diego, providing leading-edge care in patient care, biomedical research, education, and community service.
• We have two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Center, the Sulpizio Family Cardiovascular Center (opening in Spring 2011) several outpatient clinics.
• UCSD Medical Center, Hillcrest is also a designated Level I Trauma Center and has the only Burn Center in the county.
• U.S. News and World Report's 2010-2011 annual "America's Best Hospitals" report ranks UC San Diego Health System among the best in the nation in five specialty areas: Diabetes & Endocrinology, Geriatrics, Orthopedics, Psychiatry, and Pulmonary.

Billing Associate, United Health Group - Providence, RI

Billing Associate, United Health Group - Providence, RI

Description

Primary Responsibilities

• Working with revenue cycle management
• Posting deposits to patient accounts to the client profile
• Reviewing accounts on a regular basis
• Working extensively with Accounts Receivable and Denials
• Contacting insurance companies
• Banking experience would be ideal
• Background in Medical or Healthcare industry
• Experience with revenue cycle management

Qualifications

• High school education or equivalent experience
• 2+ years data entry experience is required
• 2+ years working in an office enviroment
• Microsoft Office suite (Word and Excel) experience
• Ability to type 50 wpm
• Knowledge of EOBs (Explanation of Benefits)
• Banking experience
• Healthcare experience
• Experience with revenue cycle management