Billing Technician

Ponca Tribe of Nebraska; Macy (NE); On-site; USD 42,000 - 65,000; Full time

Job summary

Ponca Tribe of Nebraska Health Center is seeking a Medical Billing Clerk to prepare, review, and submit third‑party claims to Medicare, Medicaid, and private payers. You will review EHRs, use RPMS and billing software, and apply ICD-10-CM, CPT, and HCPCS codes to ensure accurate submissions.

Ideal candidates have an Associate's Degree or two years of office/healthcare experience, with CPB/CPC preferred, and a strong understanding of payer requirements and HIPAA confidentiality.

Qualifications

• Associate's degree or equivalent two years' work experience.
• Healthcare billing, claims processing, or medical coding experience preferred.
• Certified professional biller (CPB) and/or professional coder (CPC) preferred.
• Knowledge of third-party billing procedures and payer requirements.

Responsibilities

• Prepare, review, and submit third-party claims to Medicare, Medicaid, and private insurance payers.
• Review EHRs and documentation to ensure claims are accurate and complete.
• Utilize RPMS and billing software to process claims.
• Apply ICD-10-CM, CPT, and HCPCS coding references for submissions.
• Review Remittance Advices and EOBs to identify payments, denials, and discrepancies.
• Address denials and resubmissions promptly with required documentation.
• Process crossover claims and follow up on payment status.
• Maintain knowledge of payer requirements and reimbursement policies.
• Communicate with insurers, providers, and staff to resolve billing issues.
• Protect patient confidentiality per HIPAA and laws.

Skills

Billing knowledge

Medical terminology

Communication

HIPAA compliance

Education

Associate's Degree in Business

Two years of experience in office/healthcare

Tools

RPMS

Electronic billing systems

Microsoft Word

Excel

Job description

SUMMARY

Responsible for preparing, submitting, reviewing, and correcting third-party healthcare claims to support accurate reimbursement for services provided by the Health Center. This position reviews electronic health records and billing documentation, follows payer requirements, assists with claim denials and rejections, and maintains accurate billing records while protecting confidential patient information.

ESSENTIAL DUTIES And/or RESPONSIBILITIES Include The Following

• Prepare, review, and submit third-party claims to Medicare, Medicaid, and private insurance payers.
• Review electronic health records and supporting documentation to ensure claims contain accurate and complete information.
• Utilize the Resource and Patient Management System (RPMS), electronic health records, and billing software to process claims.
• Apply knowledge of medical terminology and ICD-10-CM, CPT, and HCPCS coding references to support accurate claim submission.
• Review Remittance Advices (RAs) and Explanation of Benefits (EOBs) to identify payments, denials, rejections, and claim discrepancies.
• Research and address claim denials and rejections promptly, including submitting corrected claims and required documentation.
• Process crossover claims and assist with claim resubmissions and follow-up.
• Maintain knowledge of payer billing requirements, eligibility guidelines, and reimbursement policies.
• Communicate with insurance companies, providers, and appropriate staff to resolve billing issues.
• Maintain accurate billing records and protect confidential patient and financial information in accordance with applicable laws and organizational policies.
• Other duties may be assigned.

QUALIFICATION REQUIREMENTS

To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the duties.

EDUCATION And/or EXPERIENCE

• Associate's Degree in Business or an equivalent of two (2) years' experience working in an office or healthcare setting.
• Healthcare billing, claims processing, or medical coding experience preferred.
• Certified professional biller (CPB) and/or professional coder (CPC) preferred.

KNOWLEDGE, SKILLS, And/or ABILITIES

• Knowledge of third-party billing procedures and claims processing for Medicare, Medicaid, and private insurance.
• Familiarity with medical terminology and ICD-10-CM, CPT, and HCPCS coding
• Ability to review billing documentation, identify discrepancies, and assist with claim
• Ability to communicate effectively with insurance representatives, healthcare providers, and staff.
• Working knowledge of Microsoft Word, Excel, and electronic billing systems.
• Ability to maintain confidentiality and safeguard patient information in accordance with applicable privacy requirements, including HIPAA.

PLEASE NOTE: P.L. 93-638, Indian Preference and Tribal Employment rights Ordinance. (T.E.R.O) will be practiced; however, all qualified applicants will be considered.