Healthcare Billing & Claims Specialist

The Omaha Tribe of Nebraska; Macy (NE); On-site; USD 42,000 - 64,000; Full time

Job summary

The Omaha Tribe of Nebraska is seeking a Healthcare Billing Specialist to prepare, review, and submit third-party claims to Medicare, Medicaid, and private payers. The role requires reviewing electronic health records and documentation to ensure accuracy and compliance with payer requirements.

Experience with RPMS or similar billing systems, medical terminology, and coding (ICD-10-CM, CPT, HCPCS) is preferred.

Qualifications

• Associate's Degree in Business or two years' healthcare/office experience.
• CPB and/or CPC certifications preferred.

Responsibilities

• Prepare, review, and submit third-party claims to Medicare, Medicaid, and private payers.
• Review EHRs and supporting documentation for accuracy.
• Utilize RPMS and billing software to process claims.
• Apply ICD-10-CM, CPT, HCPCS coding to support submissions.
• Review Remittance Advices and EOBs for discrepancies.
• Research and address denials and resubmissions promptly.
• Maintain knowledge of payer requirements and reimbursement policies.
• Communicate with insurers, providers, and staff to resolve billing issues.

Skills

Billing procedures

Medical coding

Discrepancy review

Communication

MS Office & billing systems

HIPAA/privacy

Education

Associate's Degree in Business

CPB certification

CPC certification

Two years of office/healthcare experience

Tools

RPMS

Billing software

Microsoft Word

Microsoft Excel

Job description

The Omaha Tribe of Nebraska is seeking a Healthcare Billing Specialist to prepare, review, and submit third-party claims to Medicare, Medicaid, and private payers. The role requires reviewing electronic health records and documentation to ensure accuracy and compliance with payer requirements.

Experience with RPMS or similar billing systems, medical terminology, and coding (ICD-10-CM, CPT, HCPCS) is preferred.