Senior Patient Billing Representative

About the role

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. Our culture, known as The Meaning of Care, sets us apart by helping families grow through special deliveries, conveying difficult diagnoses with compassion, going above and beyond for patients' needs, and celebrating personal health victories.

Responsibilities

• Serves as a resource person for Business Office staff.
• Maintains awareness of Payer specific regulatory issues, Insurance updates and have a full understanding of departmental functions to assist with questions.
• Affords assistance in new employee training and provides feedback for employees about policies and procedures to ensure quality and consistency.
• Communicates effectively with staff, informing them of issues including backlogs in claim filing, insurance follow-up, and electronic billing.
• Identifies and addresses employee work-related issues impacting daily work flow.
• Effectively communicates Supervisor or departmental changes in policy.
• Works with Supervisor on solutions to streamline processes.
• Handles referral handling/phone calls, appropriately and timely, including second requests, referrals, and escalated patient calls from within Business Office and outside departments within the Health System.
• Manages specialized Management Referrals appropriately and timely.
• Understands challenges of leadership roles & responsibilities.
• Maintains confidentiality in all aspects of position.
• Demonstrates a Positive Attitude on a consistent basis.
• Communicates Clearly.
• Demonstrates Active Listening.
• Shows support and provides feedback on decisions that will impact process.
• Demonstrates ability to prevent conflict by focusing on issue resolution to achieve overall positive outcome.
• Avoids personal feelings or reaction regarding issue.
• Promotes Positive Team Building.
• Displays patience and tactfulness.
• Time Management.
• Displays Organizational Skills.
• Prioritizes daily workload.
• Effective use of time.
• Knowledge of System Applications and Training.
• Demonstrates ability to learn, maintain working knowledge and train staff on the following Health System Applications: * Cerner Profit / Cerner Workflow / Revenue Manager / Patient Records / Medicare Online System (FISS) / MREP / Application Xtender / PC Print / Record Link / Powerchart / Word / Excel / Outlook / all Payer Websites.

Essential Lead Functions And Responsibilities

• Provides backup for staff shortages to maintain work flow.
• Participation in in-service programs, continuing education programs and meetings as directed by Management to remain aware of all changes related to Healthcare.
• Aid Supervisor in monitoring workflow and providing data for reporting.
• Aid Supervisor in writing and maintaining procedure manuals directly relating to the efficient and accurate handling of assigned work.
• Identify and trend issues to improve or streamline processes.
• Handle as needed, Assigned special projects.
• Handling Individual Team Special duties Testing (system applications) as needed.
• Performs daily/weekly Management directed duties.

Job Requirements

• High school diploma, General Educational Development (GED) or equivalent required.
• Participate in mandatory in-service and continuing education programs as mandated by policy and procedure/external agencies as directed by supervisor.
• Requires 2 or more years of previous experience in a business office setting, in health care Third Party Reimbursement with electronic claim submission.
• Full understanding of ICD-9 and CPT-4/HCPCS coding.
• Minimum 1 year of lead or supervisory experience preferred.
• Requires prior experience with patient accounting software, payer websites, and electronic billing scrubbers and maintain working knowledge of multiple system applications.
• Health System Applications Used: Cerner RCA/Profit, Revenue Manager, Patient Records, Medicare online System (FISS), MREP, Application Xtender, Record Link, Powerchart, PC Print and/or all Payers Websites.

Skills/Knowledge/Abilities

• Full understanding of ICD-9, ICD-10, CPT-4 and HCPCS coding.
• Must demonstrate excellent communication skills.
• Ability to Identify, trend & analyze data for resolution of issues.
• Health System Applications Used: Cerner Profit, Revenue Manager, Patient Records, Medicare online System (FISS), MREP, Application Xtender, Record Link, Powerchart, PC Print and/or all Payers Websites.
• Requires Analytical ability to review high level accounts to determine appropriate action.
• Requires the ability to understand advanced accounting and business principals to enable accurate auditing of patient accounts, execution of claims scrubbers and ability to read EOB's.

Physical Requirements

• Weight Demands: Light Work - Exerting up to 20 pounds of force.
• Physical Activity: Occasionally Performed (1%-33%): Balancing, Climbing, Carrying, Crawling, Distinguishing colors, Kneeling, Lifting, Pulling/Pushing, Reaching, Standing, Stooping/bending, Twisting, Walking.
• Frequently Performed (34%-66%): Hearing, Repetitive Motions, Seeing/Visual, Speaking/talking.
• Constantly Performed (67%-100%): Grasping, Keyboarding/typing, Sitting.

About Methodist

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.

Employer Information

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.