Insurance Biller 2

📋 Description

• • Join St. Charles Health System, a leading healthcare provider dedicated to creating America's healthiest community, as an Insurance Biller 2. This is a remote position, offering flexibility to work from approved states including Oregon, Arizona, Arkansas, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Tennessee, Utah, and Wisconsin. If you do not reside in or plan to relocate to one of these states, we kindly request that you do not apply for this specific role.
• • As an Insurance Biller 2, you will play a crucial role within the Single Billing Office (SBO), a department focused on delivering a seamless and transparent revenue cycle experience for patients and customers. The SBO is responsible for a comprehensive range of services including billing insurance claims, posting payments, resolving claim denials, collecting unpaid claims, managing payer contracts within the Electronic Health Record (EHR), processing refunds, and handling patient billing inquiries.
• • This intermediate-level position involves a variety of essential billing tasks. You will be responsible for submitting facility (HB) and professional (PB) claims to insurance payers and other entities in accordance with SBO standard work. This includes preparing and submitting basic itemized statements, medical records, and other necessary documentation to payers through clearinghouses, mail, or other electronic methods.
• • A key aspect of your role will be verifying and updating insurance coverage information using EHR tools, payer websites, or direct communication with payers. You will also be tasked with resolving complex billing-related claim edits, addressing "do not bill" (DNB) and "stop bills," and managing payer rejections, such as Medicare return-to-provider (RTP) and clearinghouse rejections (277s).
• • You will expertly split and combine claims as required by specific payer guidelines. Obtaining Insurance Claim Numbers (ICNs) for pending corrected claims will be a regular duty, utilizing EHR tools, payer websites, clearinghouse or lockbox resources, or by contacting payers directly.
• • This position requires an intermediate understanding of current reimbursement methodologies as defined by the department's complexity matrix, as well as an intermediate grasp of standard billing requirements. You will also process late charges using the dedicated late charge functionality within the system.
• • Generating and releasing medical records will be part of your responsibilities, along with splitting charges to separate Health Account Records (HARs) or liability buckets, and combining charges to a single HAR when necessary. You will also be responsible for submitting corrected claims and updating claim information, including ICNs, authorizations, and other essential billing elements.
• • You will actively review and resolve billing correspondence, ensuring accuracy and timeliness. Maintaining clear and concise documentation within the patient health information system is paramount. Continuous learning is encouraged; you will be expected to obtain and maintain knowledge of current billing requirements and any changes through payer newsletters, workshops, webinars, and other applicable sources.
• • Collaboration and continuous improvement are core to our values. You will attend applicable meetings, including payer meetings and educational opportunities, to stay abreast of industry changes and best practices. You will support the organization's vision, mission, and values in all aspects of your work, embodying a spirit of accountability, caring, and teamwork.
• • Embracing Lean principles, you will function as a champion of change, contributing to continuous improvement efforts with energy and enthusiasm. Ensuring a safe environment for caregivers, patients, and guests is a shared responsibility. You will conduct all activities with the highest standards of professionalism and confidentiality, adhering to all applicable laws, regulations, policies, and procedures.
• • Upholding the organization's corporate integrity efforts, you will act ethically and appropriately, reporting any known or suspected violations and cooperating fully with investigations. Delivering exceptional customer service and patient care that is timely, efficient, and accurate is expected. This role may involve performing additional duties of similar complexity as required or assigned, contributing to the overall success of the Single Billing Office and St. Charles Health System.