PRE-BILLING CLAIMS SPECIALIST - NORTHWEST BILLING

About the role

Under the direction of the Revenue Cycle Manager, the Pre-Billing Claims Specialist will submit and process claims in accordance with payer regulations and department policies and procedures. This position ensures proper follow-up of unbilled accounts using Meditech biller worklists, contacts patients for insurance information or clarification as needed before initial bill, and performs other duties as assigned.

• Advanced knowledge of coordination of benefits and Medicare Secondary Payer requirements.
• Verify patient coverage for primary, secondary, and tertiary insurance.
• Verify third-party billing and/or auto insurance information as necessary.
• Ensure the authorization number is in the required field.
• Ensure secondary and tertiary claims have generated for billing.
• Ensure electronic claim files are created and uploaded.
• Resolve Meditech claim edits and work external Clearinghouse prebilling and payer rejections.
• Work with Team Lead and Clearinghouses to establish custom edits and resolve errors.

Requirements

• High school diploma or equivalent required.
• Proficient with billing and prebilling: Medicare, Medicaid, BCBS, and Commercial.
• Proficient with billing UB04s and HCFAs.
• Excellent written and verbal communication skills.
• Analytical; ability to research, analyze, and train on data and reports.
• Minimum of 2 years’ physician and facility billing experience.

About Northwest Specialty Hospital

Northwest Specialty Hospital is widely known as a center of excellence and is proudly owned and operated by local physicians. The hospital includes 12 operating rooms and 28 inpatient beds, along with a variety of clinics and services throughout Kootenai County, spanning multiple specialties. Northwest Specialty Hospital has earned numerous awards for patient care, surgical skill, medical care, and employee satisfaction, and has been recognized as one of the Best Places to Work in the Inland Northwest for four consecutive years.

Benefits

• Company-sponsored events such as Silverwood Days, sporting events, BBQs, and holiday parties.
• Comprehensive health care coverage with options for Medical, Dental, and Vision Insurance.
• Tuition reimbursement.
• Growth opportunities, ongoing education, training, and leadership courses.
• Generous 401K retirement plan.
• A variety of discounts throughout the hospital and community.
• Wellness benefits including weight loss challenges, access to a dietitian, and discount gym memberships.
• Culture that promotes and supports work/life balance.