Insurance Biller 2

St. Charles Health System

1d • $22 - $30 • Remote

About The Position

The Insurance Biller 2 position is an intermediate position responsible for intermediate billing tasks including resolving claim edits, addressing billing related do not bill (DNB) and stop bills, resolving payer rejections (277 or DDE), and splitting or combining claims. The level 2 position requires an intermediate understanding of payer reimbursement methodologies, standard billing guidelines, and EHR functionality. This position may work with internal and external stakeholders including SBO teams, other St Charles departments, and community entities if appropriate. This position does not directly supervise any other caregivers.

Requirements

• High school graduate or GED
• Three years of healthcare experience, of which two years must have been in billing or equivalent role.
• One year of healthcare experience may be substituted with an applicable certification (RHIT, Medical coding, etc.).
• One year of Epic experience.
• Knowledge of standard billing requirements.
• Intermediate knowledge of payer reimbursement methodologies.
• Basic skills in Microsoft Office applications including Excel, One Note, Outlook, and Word.
• Problem solving and research skills.
• Strong communication skills including ability to articulate complex technical issues impacting billing.

Nice To Haves

• Course work in medical terminology or other revenue cycle functions such as RHIT or medical coding.
• Certified Healthcare Financial Professional (CHFP), Certified Revenue Cycle Representative (CRCR), Certified Specialist Account and Finance (CSAF), Certified Specialist Payment and Reimbursement (CSPR), Registered Health Information Technician (RHIT), Certified Coding Specialist Physician Based (CCS-P), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Professional Coder (CPC), Certified Professional Biller (CPB).
• Two years of Epic experience.

Responsibilities

• Bill facility (HB) and professional (PB) claims to insurance payers or other entities per SBO standard work.
• Submit basic itemized statements, medical records, and other required information to insurance payors via clearinghouse, mail, or other electronic means.
• Verify and update insurance coverage as applicable using EHR tools, payer websites, or via phone calls to payers.
• Resolve complex billing related claim edits within EHR, DNBs and Stop Bills.
• Resolve complex payer rejections including Medicare return to provider (RTP) and clearinghouse rejections (277’s).
• Split and combine claims as required by payer.
• Obtain ICN’s for pending corrected claims using EHR tools, payer websites, other resources (clearinghouse or lockbox), or via phone call to payers.
• Apply intermediate knowledge of current reimbursement methodologies as defined by department complexity matrix.
• Apply intermediate knowledge of billing requirements as defined by department complexity matrix.
• Process late charges using the late charge functionality.
• Generate and release medical records.
• Split charges to a separate HAR or liability bucket and combine charges to a single HAR as needed.
• Submit corrected claims.
• Update claim information including ICN, authorizations, billing information, or other required claim elements.
• Review and resolve billing correspondence.
• Enter clear and concise documentation in the patient health information system.
• Obtain and maintain knowledge of current billing requirements and any changes via payer newsletters, payer workshops, payer webinars, or other applicable source.
• Attend applicable meetings including payer meetings and educational opportunities as appropriate.
• Support the vision, mission, and values of the organization in all respects.
• Support Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.
• Provide and maintain a safe environment for caregivers, patients, and guests.
• Conduct all activities with the highest standards of professionalism and confidentiality.
• Comply with all applicable laws, regulations, policies, and procedures, supporting the organization’s corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.
• Deliver customer service and/or patient care in a manner that promotes goodwill, is timely, efficient, and accurate.
• May perform additional duties of similar complexity within the organization, as required or assigned.

Benefits

• Competitive Salary
• Comprehensive benefits including Medical, Dental, Vision for you and your immediate family
• 403b with up to 6% match on Retirement Contributions
• Generous Earned Time Off
• Growth Opportunities within Healthcare

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED