Billing/Follow-Up Specialist Lead - Government Billing (Remote)

Description

PeaceHealth is seeking a Billing/Follow-up Specialist Lead - Government Billing (Remote) for a Full Time, 1.00 FTE, Day position. The general salary range for this job opening at PeaceHealth is $20.65 - $30.97. The actual hiring rate is dependent upon several factors, including but not limited to, the job/position responsibilities, location, terms of the applicable collective bargaining agreement, education, training, work experience, seniority, work performance, etc.

**Must live in Oregon, Washington, Texas or Alaska.**

This position will be performed fully remote. If telecommuting, PeaceHealth will provide the caregiver with necessary computer equipment. It is the responsibility of the caregiver to provide Internet access.

Responsible for coordinating the day-to-day functions for assigned area. Assists with ensuring that departmental goals are achieved, timelines met and service excellence provided in all aspects of work. Subject matter expert. Responsible for all phases of billing/account follow-up using accepted billing practices to ensure thorough and consistent account resolution to promote corporate financial health. Ensures acceptable reimbursement and appropriate days in Accounts Receivable via timely account follow-up and resolution of outstanding charges owed by third party payors. Responsible for all areas of billing and account follow-up including claims submission, account follow-up with insurance payors, and resolution of reimbursement issues for multi-facility, multi-specialty organization.

Position Details:

• Assigns work; plans and coordinates priorities, provides technical assistance, oversees staff schedules, monitors quality of work, monitors team projects, mentors staff, provides constructive feedback, oversees staff training, ensures quality improvement, provides leadership feedback on staff performance, and assists with goal setting for the team.
• Resolves insurance claim rejections/denials, and non-payment of claims by payors.
• Identifies trends in billing and follow-up and identifies ways in which our patients can expedite resolution of insurance accounts and identify delays in processing.
• Drafts appeals to insurance companies for reimbursement of monies owed.
• Maintains daily account, follow-up work lists within department while maintaining organization's productivity standards.
• Ensures compliance when processing claims, in accordance with contracts and policies; as well as to settle claims as appropriate.
• Identifies, researches and resolves: credit balances, missing payments and unposted cash as it pertains to billing account follow-up.
• Processes, and maintains all correspondence received from patients and insurance companies as it pertains to correct and timely billing of claims, and receipt of payment.
• Handles patient disputes and submission of issues to coding for review to ensure organizational and revenue cycle processes are followed
• Communicates appropriately with insurance companies, patients, co-workers and supervisors
• Assists with departmental coverage as needed.
• Performs other duties as assigned.

What you bring:

• High School Diploma or equivalent required.  Associates Degree preferred.
• Minimum of 3 years experience in a billing or insurance account follow-up and payment posting. Formal training or college coursework from a medical coding accredited school, specific to medical billing in lieu of experience may be considered required.
• Medical terminology experience required.
• Knowledge of insurance processes and billing guidelines regulations required.
• Medical coding knowledge preferred.
• Knowledge of medical billing systems and clearinghouse processes required.
• Epic experience preferred.
• Medical Billing Certificate, Certified Revenue Cycle Representative or HealthStream Badge preferred.

Skills

• Proficient use of computers including Microsoft Office 2010 applications (Required)
• Skilled in 10-key by touch and keyboarding (Required)
• Ability to operate general office equipment (Required)
• Exceptional verbal and written communication skills (Required)
• Excellent attention to detail and ability to multi-task (Required)
• Ability to work with minimal supervision, independently, as well as in a collaborative team setting (Required)
• Knowledge of commercial and government payers (Medicaid, Medicare, VA) and Workers Compensation. (Required)
• Strong organizational skills with the ability to prioritize and meet deadlines (Required)
• Ability to prepare and present instructional material to staff. (Required)
• Ability to identify, research, and resolve credit balances, payer recoupments, missing payments and un-posted cash as it pertains to billing account follow-up. (Required)
• Ability to work remotely with minimal oversight, independently, as well as in a collaborative team setting. (Required)

Working Conditions

Lifting

• Consistently operates computer and other office equipment.

• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

• Sedentary work.

Environmental Conditions

• Predominantly operates in an office environment.

Mental/Visual

• Ability to communicate and exchange accurate information.

• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.

PeaceHealth requires a completed Primary Vaccine Series (e.g., 2 dose monovalent Pfizer, Moderna or Novavax series or 1 dose J&J vaccine series) or be Up to Date (receiving the most recent Pfizer/Moderna bivalent vaccine/booster) for COVID-19 vaccination prior to their start date. PeaceHealth has a medical and religious exemption request process for those that are unable to receive the COVID-19 primary vaccine series due to medical/religious reasons. For caregivers that will be working in Oregon there is a personal vaccine exemption form that may be requested.