Billing Support Specialist

National Jewish Health•Denver, CO

1d•$23 - $30

About The Position

Provides billing support for the Advanced Diagnostic Laboratories (ADx) at NJH. Responsible for coordinating and monitoring the flow of billing data within the clinical laboratory departments and other information system databases. Analyzes and evaluates clinical financial data, recognizes inconsistencies, and initiates the resolution of billing problems. Assists Client Services to immediately resolve billing inconsistencies and delinquent data. Implements billing plans designed to meet timely billing deadlines, and consult the Patient Financial Services (PFS) Department when applicable. Acts as liaison between ADx and the PFS Department to facilitate problem solving. Responsible for billing data, diagnosis, discharge and exception reports generated by the billing information systems to promote accurate financial billing.

Requirements

High school diploma or GED required.
A minimum of 1 year of recent and related hospital, clerical, and medical insurance experience within a healthcare environment required.

Responsibilities

Establishes and maintains ADx financial policies and procedures.
Ensures that ADx complies with all College of American Pathologists (CAP) and HIPAA requirements.
Maintains clinical billing compliance for inpatient and outpatient (Client Accounts) with Medicare, Medicaid, Institutional Guarantors and other private insurances for accurate, successful reimbursement.
Performs database surveillance and maintenance for all billing applications and interfaces.
Maintains high standards of performance for operation of all Detailed Financial Transactions (DFTs).
Monitors billing interfaces.
Reconciles price and CPT changes for reference lab testing.
Investigates new and emerging CPT coding that will enhance the billing in the LIS including but not limited to DRGs, CPTs, 837 (Medicare exception report) and timely billing practices.
Uses LIS and HIS auditing reports to verify the accuracy of patient and client billing.
Responsible for error reports (EXR/SIN/BR) and DFTs of clinical application system.
Troubleshoots billing issues to a point of adequate resolution or until the issues are at least identified as to cause and effect.
Troubleshoots all issues related to the patient billing interface, including coordination of late charges and establishing necessary accounts in the HIS.
Instructs users of the proper use of billing application programs including: Quick-OP Admits, Sunquest GUI, Manual Billing and Charge Master Verification.
Assists with the performance of a variety of client services issues when delinquent billing data is received. Including but not limited to Admitting, Discharging and Transferring (ADT) of patient data, Insurance (Third party billing), UPIN, EDI, NPI, SSN, Diagnosis and Guarantor entry.
Processes check and credit card payments using online system.
Performs product verification/validation and document outcomes of billing software and/or hardware changes or enhancements implemented.
Moves charges when necessary to assure accurate billing derived out of the LIS and HIS.
Analyzes processes and applies critical thinking skills to the LIS and HIS and EMR systems.
Serves as a backup to the LIS staff for new client accounts.
Clerical duties may include using printers, faxes, and sending mail, deliveries to on-campus locations, requisition scanning, handling phone calls, filing, archiving, labeling, sorting, and photocopying.

Benefits

Comprehensive Medical Coverage: Multiple Cigna health plans for Colorado, regional office and remote employees. Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) available to pair with some plans.
Paid Time Off: Generous PTO accruals to use for vacation and sick days, and six paid holidays, all compliant with Colorado state sick leave regulations.
Dental & Vision Plans: Coverage effective the first of the month after hire.
Retirement Savings: 403(b) plan with employer contributions after two years.
Wellness Incentives: Earn up to $200 annually for preventive health activities.
Tuition Reimbursement: Up to $5,250 annually for full-time and part-time employees.
Child Care Assistance: Childcare Flex Spending Account (FSA) with annual employer contribution.
Loan Forgiveness: Public Service Loan Forgiveness (PSLF) eligible employer.
Disability & Life Insurance: Employer-paid plans and optional buy-up choices.
Voluntary Benefits: Full suite of coverage options such as Accident, Hospital Indemnity and Legal Plan Exclusive Discounts: Savings on local services, insurance, and RTD bus passes.