Senior Patient Billing Representative

Why Work For Nebraska Methodist Health System?

At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care a culture that has and will continue to set us apart. It's helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient's needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary

Location: Methodist Corporate Office Address: 825 S 169th St. - Omaha, NE Work Schedule: Mon - Fri, 8:00am to 5:00pm Works with end user billing staff to ensure that all job duties are done to the Health System's standards and satisfaction.

Responsibilities

Essential Functions I

Serves as a resource person for Business Office staff.

• Maintains awareness of Payer specific regulatory issues, Insurance updates and have a full understanding of departmental functions to assist with questions.
• Assist in new employee training and provide feedback for employees about policies and procedures to ensure quality and consistency.

Displays effective communications skills.

• Keeps Supervisor informed of issues to include; backlogs in claim filing, insurance followup and electronic billing. ie: FISS / Revenue Manager
• Assists in identifying Employee work related issues impacting daily work flow.
• Effectively communicates to staff any Supervisor or departmental changes in Policy.
• Works with Supervisor on solutions to streamline process.

Referral handling/phone calls.

• Appropriate timely and accurate handling of 2nd Requests, Referrals and escalated patient calls from within Business Office and outside departments within the Health System.
• Handles specialized Management Referrals appropriately and timely.

Understands challenges of leadership roles & responsibilities.

• Maintains confidentiality in all aspects of position.
• Demonstrates a Positive Attitude on a consistent basis.
• Communicates Clearly.
• Demonstrates Active Listening.
• Shows support and provides feedback on decisions that will impact process.
• Demonstrates ability to prevent conflict by:
• Focusing on issue resolution to achieve overall positive outcome.
• Avoiding personal feelings or reaction regarding issue.
• Promoting Positive Team Building
• Displays patience and tactfulness.
• Time Management
• Displays Organizational Skills.
• Prioritization of daily workload.
• Effective use of time.

Knowledge of System Applications and Training.

• Demonstrates ability to learn, maintain working knowledge and train staff on the following Health System Applications: * Cerner Profit / Cerner Workflow / Revenue Manager / Patient Records / Medicare Online System (FISS) / MREP / Application Xtender / PC Print / Record Link / Powerchart / Word / Excel / Outlook / all Payer Websites.

Essential lead functions and responsibilities.

• Provides backup for staff shortages to maintain worklfow.
• Participation in in-service programs, continuing education programs and meetings as directed by Management to remain aware of all changes related to Healthcare.
• Assist Supervisor in monitoring workflow and providing data for reporting.
• Assist Supervisor in writing and maintaining procedure manuals directly relating to the efficient and accurate handling of assigned work.
• Ability to identify and trend issues to improve or streamline processes.
• Handles as needed, Assigned special projects.
• Handling Individual Team Special duties
• Testing (system applications) as needed.
• Performs daily/weekly Management directed duties.

Job Description

Job Requirements

• High school diploma, General Educational Development (GED) or equivalent required.
• Participate in mandatory in-service and continuing education programs as mandated by policy and procedure/external agencies as directed by supervisor.

Experience

• Requires 2 or more years of previous experience in a business office setting, in health care Third Party Reimbursement with electronic claim submission. Full understanding of ICD-9 and CPT-4/HCPCS coding.
• Minimum 1 year of lead or supervisory experience preferred.
• Requires prior experience with patient accounting software, payer websites, and electronic billing scrubbers and maintain working knowledge of multiple system applications. Health System Applications Used: Cerner RCA/Profit, Revenue Manager, Patient Records, Medicare online System (FISS), MREP, Application Xtender, Record Link, Powerchart, PC Print and/or all Payers Websites.

License/Certifications

• N/A

Skills/Knowledge/Abilities

• Full understanding of ICD-9, ICD-10, CPT-4 and HCPCS coding.
• Must demonstrate excellent communication skills.
• Ability to Identify, trend & analyze data for resolution of issues.
• Health System Applications Used: Cerner Profit, Revenue Manager, Patient Records, Medicare online System (FISS), MREP, Application Xtender, Record Link, Powerchart, PC Print and/or all Payers Websites.
• Requires Analytical ability to review high level accounts to determine appropriate action.
• Must have effective communication skills for handling patient's, attorneys; Health System Staff and Insurance Companies at a professional level.
• Requires the ability to understand advanced accounting and business principals to enable accurate auditing of patient accounts, execution of claims scrubbers and ability to read EOB's.

Physical Requirements

Weight Demands

• Light Work - Exerting up to 20 pounds of force.

Physical Activity

• Occasionally Performed (1%-33%):
• Balancing
• Climbing
• Carrying
• Crawling
• Crouching
• Distinguish colors
• Kneeling
• Lifting
• Pulling/Pushing
• Reaching
• Standing
• Stooping/bending
• Twisting
• Walking
• Frequently Performed (34%-66%):
• Hearing
• Repetitive Motions
• Seeing/Visual
• Speaking/talking
• Constantly Performed (67%-100%):
• Grasping
• Keyboarding/typing
• Sitting

Job Hazards

• Not Related:
• Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (BBF)
• Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)
• Equipment/Machinery/Tools
• Explosives (pressurized gas)
• Electrical Shock/Static
• Radiation Alpha, Beta and Gamma (particles such as X-ray, Cat Scan, Gamma Knife, etc)
• Radiation Non-