Insurance Biller Collector

Insurance Biller Collector

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

As an Insurance Biller, you will provide critical support in the revenue cycle, meticulously processing and submitting claims to ensure timely and accurate reimbursement for services rendered. Every day you will expertly review patient accounts, verify insurance information, apply correct coding, and meticulously prepare and transmit claims, diligently following up on rejections and denials to maximize revenue capture. To be successful, you will demonstrate outstanding attention to detail, strong knowledge of billing regulations, and a persistent, analytical demeanor, contributing significantly to the financial health of the organization.

Job standards include performing daily billing functions for assigned accounts receivable claims to ensure claims resolutions within set deadlines, maintaining average QA percentage at a rate established for the fiscal year goal, performing follow up on any outstanding accounts and obtaining commitment for payment from insurance carrier, sending out daily appeals to insurance companies for denied claims to maintain consistent cash flow of assigned A/R, resolving incoming correspondence or telephone inquiries in a timely manner in accordance with payer deadlines, and identifying trends and patterns in claims processing and participating in process improvement.

System support includes documenting on system all actions taken on account so that it clearly communicates action taken, demonstrating knowledge and use of Cerner, the billing clearing house, and other related PFS software.

Administrative support includes displaying competency in the use of departmental equipment, performing routine assignments independently, consistently prioritizing workload, offering assistance to co-workers, and seeking help when necessary. Reports problems, questions or suggestions to immediate supervisor. Consistently follows departmental chain of command. Defuses potential problems or conflicts by handling situations, referring to Supervisor/Manager/Director, or following departmental policies.

Personal and professional responsibility includes maintaining current knowledge regarding area of expertise, keeping up to date on billing changes, attending PFS departmental meetings.

Required job experience includes two years hospital billing/collection experience or other related healthcare provider claims experience in a high volume medical healthcare claim environment, AHCCCS/Medicare/government commercial payer experience, UB-04 billing experience, high school graduate or diploma, and previous experience with computerized billing systems, word processing and spreadsheet applications.

Preferred job experience includes four years hospital billing/collection experience or other related healthcare provider claims experience in a high volume medical healthcare claim remote environment, college level business courses, two years relevant college education and experience, experience with Google Workplace applications, billing clearing house and Cerner.