Patient Accounts - Government Payers - Insurance Biller - FT - 1st Shift Job Listing at Wilson Health in Sidney, OH (Job ID 8a7887a89a320872019a4b82195c603b)

Description

Wilson Health is seeking a full-time, experienced Government Payers - Insurance Biller -  for our location in Sidney, Ohio.   Key Perks and Benefits:

• Access to Employer Direct Care Clinic.  Free medical care and pharmacy services for all benefit eligible employees.  Dependents are eligible for free medical care if they are covered by Wilson Health's medical insurance plan.
• Generous paid time off program beginning day one of employment.
• Medical Insurance: Choice of Two High Deductible Health Plan Options or a PPO, Dental and Vision Insurance. Coverage begins the first day of the month after hire.
• H S A with employer contribution for eligible health plans, FSA for medical and dependent care expenses.
• Company Paid Life Insurance, Short-Term, and Long-Term Disability Insurance.
• Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance.
• Industry leading retirement plan- employer contributions begin day one, no waiting period for participation.
• Tuition Assistance Program
• On site employee fitness center
• Discounted Child Care Program

Employment Status: Full Time - HYBRID                 Position Reports To: Manager, Patient Accounting Working Hours: Monday – Friday, Flexible Working Hours, Begin as Early as 6:30 am. Option for either 8 or 9 hour work day.   Who We Are: At Wilson Health, our mission is to improve the health and wellness of our communities by delivering compassionate, quality care. We are committed to making a difference for our neighbors, friends, and family and our vision is to be a trusted, nationally recognized leader of innovative, collaborative community health.   POSITION SUMMARY: Under the direction of the Director and Supervisors of Patient Accounts, the Billing Specialist releases claims electronically and mails hard copy UB/1500 claims as required. The Billing Specialist will follow up on unpaid claims and rebill or appeal claims as indicated. Billing Specialist will review claims and ensure claims are not rejected or pending.   KEY DUTIES AND RESPONSIBILITIES:

• Experience with Electronical Health Records (EHR) -  EPIC preferred. Microsoft Office/Excel Experience preferred.
• Billing of claims through Electronic Vendor (Quadax) which requires keeping up to date with Payer requirements and/or edits.
• Submits claim electronically or hard copy for MSP claims with appropriate information from the primary payer.
• Bills secondary, tertiary, etc. claims electronically or mails the UB/1500 with EOB as required by Payer.
• Monitors claims using the EMR, Medicare Website and/or Quadax.
• Works closely with all departments throughout the hospital regarding charges.
• Responsible for the follow up of submitted claims to primary, secondary, and tertiary payers.
• Contacts Payers via phone or Payer web site regarding no pays.
• Appeals claims on behalf of the patient to secure payment or if a claim has been denied for inappropriate reasons. Biller will also follow up on the appeal.
• Works with Case Management and Medical Records regarding RAC audits, other audits, and inpatient denials.
• Works mail as it applies to the Biller to secure payment.
• Works closely with Central Scheduling/Registration, Case Management and Medical Records regarding Denials for No Authorizations and/or Medical necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal.
• Submits documentation to Manager of Patient Accounts for refunds.
• May receive phone calls from patients regarding account balances, itemized bill or Explanation of Benefits.

OTHER SKILLS and ABILITIES:

• Accurate typing skills, computer keyboard skills and data entry.
• Knowledge of medical terminology, CPT and HCPCS codes.
• Ability to work in a highly stressful environment.
• Ability to adapt to change.
• Organization and prioritizing skills.
• Ability to communicate with co-workers.

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The ability to communicate with a professional friendly personality to the customer is essential. Internet skills and the ability to navigate through different systems.

EDUCATION and/or EXPERIENCE: High school diploma or general education degree (GED) and minimum of one-year experience and/or training; or equivalent combination of education and experience. EPIC billing experience REQUIRED   Mission & Vision & Values:

• Improve the health and wellness of the community by delivering compassionate, quality care.
• Be a trusted, nationally recognized leader of innovative, collaborative, community health.
• A.S.P.I.R.E - Always serve with professionalism, integrity, respect, and excellence.

EOE (Equal Opportunity Employer)  

 Apply on company website