25 days old

PBS Operations Support

Huggins Hospital
Wolfeboro, NH 03894
  • Job Code
Under the immediate supervision of the Director of Revenue Integrity, is responsible for working under the direction of the Billing Supervisor to assist with ensuring all charges are processed and billed accurately and in a timely manner. Serves as mentor and resource to fellow billers, cashier and other team members of the Revenue Cycle. This individual will assist with responding to daily operations as directed by the Billing Supervisor.
This is a full-time position working 40 hours per week.
Assists with oversight of daily operations of the billing department by ensuring timely and accurate billing and follow-up practices are occurring in accordance with specific payer requirements. Reviews aging reports and claims with billers to determine viable payment resolution strategies. Recommends and institutes methods for billing to improve performance. Monitors claim edits and holds within all Patient Business systems, clearinghouses and other insurance carrier and vendor systems.
Demonstrates billing proficiency and compliance by acquiring and maintaining a thorough knowledge of legislative and administrative actions affecting billing processes and ensures departmental compliance. Demonstrates proficiency in the areas of Medicare billing regulations governing MSP, LCD's, NCD's, ABN's and FISS. Expertise in all carriers, individual payer requirements, timely filing limits and appeal time limits. Knowledgeable in the area of CAH billing, providing guidance to fellow billers in this area. Reports and assists in investigating any potential compliance issues.
Assist and support Director and Billing Supervisor with billing issues and establishing, implementing and verifying adherence to controls that maintain appropriate claim submission, billing, and reimbursement practices. Advises Director and Billing Supervisor of "unusual" conditions which require action or intervention. Performs routine quality assurance checks of claims prior to submission to prevent denials; regularly tracks rejected claims and initiates correction, follow-up, and appeals process as appropriate. Working with billers, determines viable payment resolution strategies. Assists with coordinating, and implementing ongoing staff training, and education.
Functions as Subject Matter Expert (SME) as relates to billing functions to assist with the implementation of the new EMR software. Assist Billing Supervisor with maintaining tables in the SFM product that governs the production of claims, such as insurance tables, EDI tables, and 835/837, tables, etc. SME of the Edit process within software to ensure that edits are applicable and process correctly within both the EMR and Assurance Clearing House product. Assist with oversight of CARC and RARC code process to ensure adjustments and postings are done correctly.
  • Education: High School Diploma or equivalent, Associates Degree preferred, or equivalent combination of education and experience.
  • Experience: 3-4 year experience as a Hospital Biller. Demonstrated technical ability relative to healthcare billing functions and keen attention to detail.

Posted: 2021-03-26 Expires: 2021-04-24
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PBS Operations Support

Huggins Hospital
Wolfeboro, NH 03894

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