Patient Billing & Claims Specialist I

Nebraska Methodist Health System; Omaha (NE); On-site; USD 42,000 - 56,000; Full time

Job summary

Nebraska Methodist Health System is seeking a Billing Specialist to manage electronic and paper billing, claim submission, and follow-up activities for patient accounts. The role emphasizes accurate data handling, adherence to payer guidelines, and timely communications with payers and patients.

The position requires familiarity with UB04 and CMS1500 data, and prior experience in healthcare billing is preferred.

Qualifications

• Skill in interpreting UB04 and CMS1500 claim data to troubleshoot edits and resolve payer requirements.
• Ability to create and submit both original and corrected claims.
• Ability to audit accounts and payer explanations of benefits (EOBs) for action.
• Ability to use effective communication skills with patients, payers and staff.
• Knowledge of accounting and business principles to audit patient accounts.
• Ability to follow up with third-party payers for claims and appeals.
• Ability to maintain knowledge of multiple system applications.

Responsibilities

• Electronic and hardcopy billing following department and payer guidelines.
• Submit UB04/837I and CMS1500/837P claims; prepare secondary/tertiary billings.
• Audit and update billing data; ensure accurate reimbursement.
• Handle referrals timely and document inquiries in Source System.
• Review and maintain accounts using the Patient Accounting System.
• Follow up with third-party payers using payer websites and tools.
• Complete assigned projects timely; manage daily workflow queues.

Skills

Billing software

Claims processing

Communication skills

Auditing

Customer service

Education

High school diploma/GED or equivalent

AHIMA coursework in Coding, Billing or Healthcare Management preferred

Tools

UB04 data

CMS1500 data

Source System

Job description

Nebraska Methodist Health System is seeking a Billing Specialist to manage electronic and paper billing, claim submission, and follow-up activities for patient accounts. The role emphasizes accurate data handling, adherence to payer guidelines, and timely communications with payers and patients.

The position requires familiarity with UB04 and CMS1500 data, and prior experience in healthcare billing is preferred.