Government Biller

20 Northeast Georgia Medical Center, Inc.

United States

On-site

USD 42,000 - 54,000

Full time

6 days ago

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Job summary

Northeast Georgia Health System is seeking a Revenue Cycle professional to bill third-party claims to governmental payers and perform insurance collection duties on delinquent balances. The role requires reviewing accounts for prior collection activity, maintaining clear documentation, and managing communications with payers and employers to expedite payments.

The ideal candidate will have knowledge of governmental payer systems, UB04 data, and strong problem-solving and communication skills,

Qualifications

High school diploma or GED required; 1 year minimum collection experience.
Knowledge of governmental billing regulations and UB04 data.
Experience with claims processing software and HealthPort e-request system preferred.

Responsibilities

Thoroughly review and submit claims after evaluation.
Review accounts for delinquent balances and collect accordingly.
Contact insurers and employers to expedite claim processing and payment.
Document collection activities clearly in the system for auditability.
Assist Revenue Cycle teams with insurance collection matters as needed.

Skills

Governmental billing knowledge

DDE & MMIS proficiency

UB04 data knowledge

Excellent communication skills

Teamwork and multitasking

Education

High School Diploma or GED

Tools

Claims processing software

HealthPort e-request system

Job description

Job Category: Revenue Cycle Work Shift/Schedule: 8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role: Job Summary

Bills third party claims to governmental payers. Performs insurance collection duties on delinquent insurance balances. Reviews accounts for previous collection activity and appropriately proceeds with collection activities. Manages communications with payers and employers as appropriate. Maintains clear and concise documentation of collection activities.

Minimum Job Qualifications

Licensure or other certifications:
Educational Requirements: High School Diploma or GED.
Minimum Experience: One (1) year minimum collection or business office experience.
Other:

Preferred Job Qualifications

Preferred Licensure or other certifications:
Preferred Educational Requirements:
Preferred Experience: Previous hospital and or insurance collection experience.
Other:

Job Specific and Unique Knowledge, Skills and Abilities

Extensive knowledge of governmental billing regulations and collection procedures
Proficiency with governmental payer systems to include DDE and MMIS
Thorough knowledge of Third Party Billing guidelines and UB04 data
Teamwork skills necessary
Ability to multi-task by working in various systems simultaneously
Excellent problem solving and analytical skills
Excellent verbal and written communication skills

Essential Tasks and Responsibilities

Ability to thoroughly review and understand all documentation in the NGMC Patient Accounting core system.
Proficiency is required in the claims processing software.
Thoroughly reviewing claims and making necessary corrections prior to submission to the payer.
Maintains the number and dollar amount of claims held in the billing scrubber to the expected minimum levels, alerting supervisor promptly if unable to resolve an error within 24 hours.
Identify, retrieve, print and mail hard copy claims for non-electronic payers, i.e. workers compensation and auto insurance.
Resolve claim rejections daily and work with supervisor to "root cause" and report to the appropriate departments on a regular basis.
Contacts insurance companies via telephone and websites to expedite claim processing and payment.
Completes Medical Records requests as needed via the HealthPort "e-request" system.
Documents the patient account thoroughly and accurately in order to leave sufficient information for any other party reviewing the account for future collection efforts, which may include presentation in court.
Assists other Revenue Cycle departments in dealing with insurance collection matters.
Documents collection efforts in the "Receivables Workstation" system to accurately identify insurance denial/delay root causes.
Contacts patients and/or responsible parties to inform them of documents or information needed for insurance to process claim for payment.
Actively participates in the "Governmental Payer" team, including visual management and LEAN problem solving activities.
Submits secondary claims electronically and/or hard-copy with the necessary primary payer information.
Researches core HIS system to root cause charge variances and establish plan to resolve accounts.
Work special projects related but not limited to charge reconciliation and bad debt processing.
Works time sensitive AR reports on demand.

Physical Demands

Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
Weight Carried: Up to 20 lbs, Occasionally 0-30% of time
Vision: Heavy, Constantly 66-100% of time
Kneeling/Stooping/Bending: Occasionally 0-30%
Standing/Walking: Occasionally 0-30%
Pushing/Pulling: Occasionally 0-30%
Intensity of Work: Occasionally 0-30%
Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. NGHS: Opportunities start here.

Equal Opportunity Statement

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.