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Northeast Georgia Health System · 2 days ago

Government Biller - Mon - Fri 8:00am - 4:30pm- Hybrid - MUST be able to be on-site in Gainesville

United States

Full-time

Hybrid

Entry Level

1+ years exp

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities. They are seeking a Government Biller to handle third-party claims to governmental payers, perform insurance collection duties, and manage communications with payers.

AssociationCommunitiesFitnessHealth Care

Responsibilities

Bills third party claims to governmental payers

Performs insurance collection duties on delinquent insurance balances

Reviews accounts for previous collection activity and appropriately proceeds with collection activities

Manages communications with payers and employers as appropriate

Maintains clear and concise documentation of collection activities

Ability to thoroughly review and understand all documentation in the NGMC Patient Accounting core system

Proficiency is required in the claims processing software

Thoroughly reviewing claims and making necessary corrections prior to submission to the payer

Maintains the number and dollar amount of claims held in the billing scrubber to the expected minimum levels, alerting supervisor promptly if unable to resolve an error within 24 hours

Identify, retrieve, print and mail hard copy claims for non-electronic payers, i.e. workers compensation and auto insurance

Resolve claim rejections daily and work with supervisor to 'root cause' and report to the appropriate departments on a regular basis

Contacts insurance companies via telephone and websites to expedite claim processing and payment

Completes Medical Records requests as needed via the HealthPort 'e-request' system

Documents the patient account thoroughly and accurately in order to leave sufficient information for any other party reviewing the account for future collection efforts, which may include presentation in court

Assists other Revenue Cycle departments in dealing with insurance collection matters

Documents collection efforts in the 'Receivables Workstation' system to accurately identify insurance denial/delay root causes

Contacts patients and/or responsible parties to inform them of documents or information needed for insurance to process claim for payment

Actively participates in the 'Governmental Payer' team, including visual management and LEAN problem solving activities

Submits secondary claims electronically and/or hard-copy with the necessary primary payer information

Researches core HIS system to root cause charge variances and establish plan to resolve accounts

Work special projects related but not limited to charge reconciliation and bad debt processing

Works time sensitive AR reports on demand

Qualification

Governmental billing regulationsDDEMMIS proficiencyThird Party Billing guidelinesClaims processing softwareAnalytical skillsMulti-tasking abilityProblem solving skillsVerbal communication skillsWritten communication skillsTeamwork skills