Acute Claim Biller - UB04 & CMS-1500 (eClinicalWorks)

cpsi; United States; On-site; USD 55,000 - 75,000; Full time

Job summary

CPSI is seeking an Acute Claim Biller to manage UB04 and CMS-1500 claims for acute hospital and rural health settings. This role requires delivering complete business office services, including patient billing and collections, and coordinating daily activities.

You will handle claims processing, payer relations, and insurance claim preparation while ensuring accuracy, timeliness, and compliance with procedures and customer-specific policies.

Qualifications

• 3–5 years of full-cycle billing experience including acute hospital and physician claims.
• Experience with claims and denial work queues.
• Proficiency with eClinicalWorks EMR is required.
• Familiar with Commercial, Workers' Comp, and VA claims.
• Strong organizational, multitasking and time-management skills.

Responsibilities

• Coordinate patient billing, credit and collections, and data entry.
• Support third-party payer relations and insurance claims.
• Ensure timely and accurate billing in line with procedures.
• Meet production and quality assurance standards consistently.
• Maintain confidential customer information and follow policies.
• Assist manager with coaching, training and team projects.

Skills

Attention to detail

Time management

Multi-tasking

Organizational skills

Customer service

Education

High School Diploma or equivalent

Tools

eClinicalWorks EMR

Job description

Job Summary

The Acute Claim Biller - UB04 & CMS-1500 (eClinicalWorks) position is responsible for day-to-day execution of complete business office services. This position is responsible for providing claims processing services to Critical Access Hospital (UB-04) and Rural Health Clinic (CMS-1500) facilities. This includes coordinating the day to day activities of a hospital's or clinic's business office such as patient billing and collection, third-party payer relations, and/or preparation of insurance claims.

Essential Functions:

• Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry.
• Recommends new processes and changes in current processes.
• Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures
• Implements appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts
• Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third-party requirements
• Responsible for consistently meeting production and quality assurance standards
• Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
• Updates job knowledge by participating in company offered education opportunities
• Protects customer information by keeping all information confidential
• Processes miscellaneous paperwork
• Ability to work with high profile customers with difficult processes
• May regularly be asked to help with team projects
• Responsible for assisting manager in the management of employees which would include coaching, training and performing necessary disciplinary actions including following up on action plans for their employees.
• Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
• Ensures employee compliance with dress code, attendance and other company policies.
• Processes miscellaneous paperwork and performs other administrative duties as assigned.

Minimum Requirements:

Education/Experience/Certification Requirements

• At least 3-5 years Full-Cycle billing experience, to include BOTH Acute Hospital and Physician (Profee) claims
• Experience with Claims AND Denial work queue's
• Experience using eClinicalWorks E.M.R - REQUIRED
• Familiar with Commercial, Workers Comp, and VA claims REQUIRED
• Strong organizational, multi-tasking, and time-management skills.
• Must be detail oriented and able to follow through on issues to resolution.
• Must be able to act both independently and as a team member.
• High School Diploma or equivalent combination of education and relevant experience needed.
• Excellent critical thinking, organizational, and time management skills with a strong attention to detail, accuracy, and follow through