Biller I | Home Plus Pharmacy

Posted 3 days ago

rapid city medical centerRapid City (SD)

Billing and Posting Clerks Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

SENIORITY

Junior

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About the role

Claims Processor Perform duties necessary to ensure the proper interpretation, processing, recording, approval and payment of inpatient and outpatient medical claims. Accurately reviews information for processing claims into a computerized system in accordance with the primary payer specifications and billing guidelines. Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include: Supportive work culture Medical, Vision and Dental Coverage Retirement Plans, Health Savings Account, and Flexible Spending Account Instant pay is available for qualifying positions Paid Time Off Accrual Bank Opportunities for growth and advancement Tuition assistance/reimbursement Excellent pay differentials on qualifying positions Flexible scheduling

Essential Functions: Demonstrates application of compliance standards and payer specific data to properly file claims and ensures prompt, appropriate reimbursement of services and supplies billed to third parties and appropriate payment of services and supplies due from patients, as evidenced by documentation, observation and feedback. Demonstrates a working knowledge of third party payer procedures including, but not limited to: Commercial Payers, Veterans Administration, worker compensation, third-party liability, county payers, and all other third party contractual agreements as required. Conducts timely follow up of claims. Use tools provided to track and trend patterns of claim submission issues that might require Compliance and Charge master staff to resolve, or HIPAA transaction code set review. Research payer requirements and offer suggestions to leadership for claims submission issues. Maintains and updates appropriate system documentation to provide information regarding claim processing to internal or external customers. Identifies unresolved requests of patient responsibility and transfers account to self pay. Performs duties and provides best customer service using behaviors that demonstrate responsibility and accountability. Participates in departmental activities related to performance improvement and quality control. Demonstrates a working knowledge of denial follow up and first level appeals. All other duties as assigned.

Additional Requirements

Required: Education - High School Diploma/GED Equivalent in General Studies

Preferred: Experience - 1+ years of Clerical Experience; 1+ years of Medical Patient Accounts/Financial Services Experience Education - Bachelors degree in Accounting, Business, Health Related Field Certifications - Certified Clinical Account Technician (CCAT) - Accredited University or accredited training professionals; Certified Patient Account Technician (CPAT) - Accredited University or accredited training professionals Sedentary work - 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, including the human body. Sedentary work involves sitting most of the time.

Job Category: Finance

Job Family: Insurance Services

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