Healthcare Billing Specialist: Claims & Reimbursement

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

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.