Epic Resolute - PB Claims Biller

TruBridge, Inc; United States; Remote; USD 45,000 - 75,000; Full time

Job summary

TruBridge, Inc. seeks a PB Epic Claims Biller to act as a liaison with hospitals and clinics, billing payer submissions and pursuing full reimbursement.

The role requires handling hospital, hospital-based physician and clinic claims, ensuring documentation, and resolving denials while maintaining confidentiality and compliance with HIPAA and ERISA. You will work with TruBridge management and hospital staff, meeting production targets and providing quality service to payers.

Qualifications

• 3 years of physician/ambulatory billing (Full Cycle) experience.
• PB Epic experience within the past 3 years.
• Experience in CPT coding and ICD-10 coding.
• Familiarity with medical terminology.
• Ability to communicate with various insurance payers.
• Experience filing claim appeals to maximize reimbursement.
• Strong written and verbal communication; ability to multi-task.

Responsibilities

• Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers electronically or by paper.
• Secures required medical documentation from third-party payers.
• Follow up with insurance carriers on unpaid claims until paid or balance remains.
• Remediation of claim rejections and resubmission of corrected claims.
• Meet production and quality standards; maintain confidentiality of information.

Skills

Billing

CPT coding

ICD-10 coding

Medical terminology

Written communication

Verbal communication

Multi-tasking

Tools

PB Epic

Job description

Job Summary

The PB Epic Claims Biller position is responsible for acting as a liaison for hospitals and clinics using TruBridge's complete business office services. They work closely with TruBridge management and hospital employees to bill insurance companies for all hospital, hospital-based physician and clinic bills. They pursue collection of all claims until payment is made by insurance companies; and perform other work associated with the billing process. These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job related duties as required. Goals and objectives are subject to change. All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.

Essential Functions

In addition to working as prescribed in our Performance Factors specific responsibilities of this role include: Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing. Secures needed medical documentation required or requested by third party insurances. Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains. Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers. 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. Ensure all claims are submitted daily with a goal of zero errors. Timely follow up on insurance claim status. Reading and interpreting an EOB (Explanation of Benefits). Respond to inquiries by insurance companies. Denial Management. Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles. Review late charge reports and file corrected claims or write off charges as per client's policy. Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer's rules and the client's policy. Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer.

Minimum Requirements

Education/Experience/Certification Requirements 3 years of physician/ambulatory billing (Full Cycle) experience REQUIRED PB Epic experience REQUIRED (within the past 3 years) Computer skills. Experience in CPT and ICD-10 coding. Familiarity with medical terminology. Ability to communicate with various insurance payers. Experience in filing claim appeals with insurance companies to ensure maximum reimbursement. Responsible use of confidential information. Strong written and verbal skills. Ability to multi-task.

Business Support

What's it like to work for TruBridge? You'll help connect providers, patients and communities with innovative solutions that create real value by supporting both the financial and clinical sides of healthcare delivery. You'll be part of a remote team that's encouraged to push boundaries and look at things differently. And you'll contribute to supporting providers in delivering the best care possible for their communities.

Are you ready to help us clear the way for care?