Nebraska Methodist College ยท 1 month ago
Patient Billing/Follow up Rep
Methodist Corporate Office - Omaha, NE
Full-time
Onsite
Entry Level
1+ years expNebraska Methodist College is part of the Nebraska Methodist Health System, which focuses on providing exceptional care to communities. The Patient Billing/Follow up Rep is responsible for billing, electronic claims submission, follow-up, and collections of patient accounts.
Higher Education
Responsibilities
Bills all non-EDI Primary Health Plans both UB04 & 1500
All claims billed on a daily basis are to be submitted same day unless there is a system problem
Submits claims according to payer specific guidelines
Ensures claims are submitted to appropriate Payer physical address
Bills all health plans electronically, both UB04's and/or 1500's in an accurate and timely manner for appropriate reimbursement
All claims are to be billed daily with exception of claims Pended, on Hold or if system problems. Exception claims must be fully documented
Submits claims according to payer specific guidelines
Prepares secondary and tertiary billings, manually and electronically on UB04's and 1500's for accurate reimbursement
Obtains appropriate EOB's through use of Resources - Intenal/External Electronic systems listed: MREP, Application Xtender, Revenue Manager, PC Print, QMS and/or Individual Payer Websites
Claims billed in the time frame set by Department
Submits claims according to Payer specific guidelines
Reviews Claims and determines appropriate action to be taken by understanding and navigating the Electronic Billing Software
Daily prioritize, sort and maintain claims based on status for timely handling. ie: Rejects/Invalids/Pends/Denied and Holds
Identifies and works electronic claim edits from a payer perspective
Reviews Revenue Manager Claim Detail Screens to ensure data is appropriate for claim submission
Ensure that claim corrections identified in Rev Manager are appropriately updated in Source System
Review and Follow Up of accounts to ensure appropriate 3rd Party Payer reimbursement is received through to closure of Account
Prioritize, maintain 11 Workflow Queues on daily basis
Appropriate use of resources: Internet, Record Link, Powerchart, Telephone, All Payer Websites, FISS, Email to obtain information to resolve patient accounts
Ensure Daily/Weekly/Monthly Reports are accurately and timely
Perform audits on all accounts to verify balance is accounted for and appropriate action is taken
Processes all daily Mail and Referrals received in an accurate and timely manner
Mail/Correspondence to be processed following department guidelines of 5 days from receipt
Referrals to be processed following department guidelines of 5 days from initial receipt
Documents in the appropriate records system any action taken in handling accounts
Appropriate documentation in Source system when necessary
Complete and accurate documentation must be added immediately following action taken on accounts
Who, what, where, when documentation method ID used in documentation process
Uses proper abbreviations and demonstrates professionalism and consistency in documentation
Patient complaints are handled in a timely and appropriate fashion
Works patient complaints as a high priority within 24 hours
Notifies patient of final results of account handling in question in a timely manner
Documentation of all patient calls
Professional courtesy expected when working directly with patient
Consistent handling of Telephone calls
Professional/Courteous responses when communicating with customers both internal & external
Timely follow up with responses
Proper use of Telephone by following department guidelines on personal use of business telephone
Qualification
Required
High school diploma, General Educational Development (GED) or equivalent required
Requires basic navigation skills in Microsoft Office applications, including Outlook, Excel, Powerpoint and Word
Requires the ability to learn how to prepare and process third-party billing to include the ability to read an explanation of benefit and account auditing experience
Requires the ability to navigate, obtain information online
Requires the ability to learn & maintain working knowledge of the following systems: Cerner Patient Accounting, Revenue Manager, Medicare Online System (FISS), MREP, PC Print and/or all Payers Websites
Requires analytical ability to review accounts to determine appropriate action
Requires effective communication skills for handling patient's, attorneys; inter departmental staff and Insurance Companies at a professional level
Requires the ability to understand basic accounting and business principals to enable accurate auditing of patient accounts, execution of claims scrubbers and ability to read EOB's
Light Work - Exerting up to 20 pounds of force
Preferred
1-2 years of experience in health care third party billing and/or claims processing preferred
Preferred knowledge of ICD-9, ICD-10, CPT-4 and HCPCS coding
Benefits
Competitive pay
Excellent benefits
Company
Nebraska Methodist College
Established in 1891, Nebraska Methodist College is a private, fully accredited nursing and healthcare professions college and an affiliate of Methodist Health System.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Sarah Murphy
Chief Student Officer & Dean of Students
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