Benefis Health Systems Hospital Government Biller Collector in Great Falls, Montana
Responsible for accurate and timely submission of government claims and resolution of government assigned accounts receivable. Contacts government payers or accesses electronic media regarding claim payment and resolution. Answers insurance rep or patient account questions for resolution of claims. Ensures that assigned account inventory does not age beyond acceptable standards in accounts receivable and follow up efforts are effective.
DUTIES AND RESPONSIBILITIES: Demonstrates a working knowledge of government payer regulations and billing requirements and resolves government claims timely and accurately. Responsible for reporting daily claim volume, holds and RTP’s. Investigates missing claim files. Processes credit balances for traditional Medicare and Montana Medicaid based on guidelines. Resolves claims holding for 72/24 hour review, readmission, and is familiar with all government payer requirements Including proper billing of MSP claims and medical necessity processes where an ABN is required. Resolves assigned billed receivables timely so that assigned aged receivables is consistently maintained within best practice standards. Performs effective follow up activities accurately and timely and documents the appropriate level of detail to maintain a record of all resolution attempts and activities. Responsible for all denials including working in the denial desktop on a daily basis to maintain minimum write offs. Responsible for filing appeals. Works late charge report daily. Meets performance standards as established by department leadership to ensure inventory of assigned work is resolved from the AR timely and accurately. Including proration report, high dollar report and any other report as assigned. Escalates difficult claims to Management when appropriate to ensure timely resolution. Documents all claim hand-offs and follows up to ensure claim was resolved. Keeps Management informed of government payer issues and other delays with claims. Assists with quantifying trends so that Management may resolve issues with the payers and/or other departments or issues impacting timely claim submission. Utilizes all tools available appropriately to maximize resolution of accounts and positively impact cash and AR performance. Ensures all coverage has been exhausted for accounts under question before assigning remaining balances to patients. Generates and prints itemized bills and pulls EOB’s for patients and insurance companies when requested or to review the accuracy of payments received on a claim when necessary. Handles all correspondence received from insurance companies and patients as needed, making sure to accurately and effectively resolve claims. Assists Management with identifying areas of opportunity to improve the government billing and collections performance. Keeps up to date and updates Management with all Medicare/Medicaid NCCI, LCD, NCD and MUE edits and updates. Works assigned schedule to ensure the collection process is not delayed. This includes working with other staff in such a way that the follow-up area is always covered. Any time off must be approved by Management. Identifies and corrects billing information when applicable; updates patient demographic or financial information as needed. Prioritize and answers any questions from patients/families concerning account balances in a timely manner established by Management. Maintains a good working relationship with other departments and staff to ensure correct coding, billing and charge accuracy for accounts in assigned responsibility. Demonstrates the ability to be flexible, organized, accurate and deal with a variety of people under stressful situations. Understands you may be required to assist with other team members work load as needed. Understand what money goal is each month and how much money is needed to meet/reach goal. Accepts other duties as assigned. Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations. Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict.
High School diploma or equivalent required
Two years prior Patient Business Services experience or equivalent of 2 years previous experience in a Healthcare Field.
Knowledge of CPT/HCPCS along with ICD-9, ICD-10 coding terminology.
Knowledge of Medicare and Medicaid billing requirements as well as all commercial payers.
Knowledge of Medicare and Medicaid NCCI, LCD, NCD and MUE edits and all updates.
Benefis Health System
The medical and professional staff at Benefis is wholly committed to delivering award-winning, comprehensive patient care. With a patient community of nearly 230,000 and a vast service area, we are the major referral hospital for the northcentral Montana region. But if you take a closer look, you'll see that we're much more than a hospital. Benefis is an entire health system, including a cancer institute, bariatric institute, heart and vascular institute, orthopedic center, senior care center, home health, health and wellness facility and much more.
Great Falls, Montana, rest on the high plains along the Rocky Mountain Front and is centrally located between Glacier National Park to the north and Yellowstone Park to the south. Residents thrive on our wide-open spaces, small town feel and big city services. A warm welcome awaits you in Great Falls.
Date Posted: Posted 2 month(s) ago
Job Family: ADMIN SUPP
Location: Great Falls, Montana