Billing Representative

Essentia Health; Fargo (ND); On-site; USD 42,000 - 56,000; Full time

Job summary

Essentia Health in Fargo, ND is seeking a healthcare billing specialist responsible for processing paper and electronic claims to payers with complete information to maximize reimbursement.

The role requires handling work queues in the patient accounting system, applying claim edits, and collaborating with insurers and internal teams to improve payment turnaround while maintaining excellent customer service.

Qualifications

• 1 year of healthcare billing, revenue services, or coding experience
• Medical certification or degree preferred

Responsibilities

• Process claims to payers with full information to maximize payment.
• Submit accurate and timely claims to prevent denials.
• Review submissions to expedite first-time payment.
• Collaborate with insurers, credentialing, and internal stakeholders to improve revenue cycle.

Skills

Customer service

Education

Medical certification or degree

Job description

Job Description:

Processes paper and electronic claims to payers with full and complete information to satisfy and facilitate the claim for payment. Produces accurate and timely claims in order to prevent denials and maximize reimbursement. Responsible for working assigned work queues within the patient accounting system and claim scrubber edits prior to final submission. Responsible for optimizing the claim submission operations including prospectively reviewing submissions and making corrections to expedite first time payment to the extent possible. He/ she is also responsible for research and communication of payer, HIPAA or other regulatory changes affecting the billing of health insurance claims and making recommendations regarding billing and system operations to improve payment turnaround. This position works closely with insurance companies, credentialing, access and managed care and other internal and external stakeholders tied to the billing system. Makes recommendations regarding system changes to improve the revenue cycle process and quality, and works to assist in the development of training. Position requires high level of customer service skills to establish and enhance positive relationships with patients, colleagues, and others. Depending upon location responsibilities may vary and may include a variety of duties of similar scope and responsibility.

Education Qualifications:

Preferred Qualifications:

• 1 year of healthcare experience in healthcare billing, revenue services, or coding- medical certification or degree