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Biller / Collector - Grants New Mexico

Company: Cibola General Hospital
Location: Grants, New Mexico
Posted On: 05/02/2025

JOB SUMMARY
Provides billing and collections on behalf of the patient for all of the following: Medicare, Medicaid, Commercial insurance, any government agencies, and all third-party liability claims. Responsible for tracking multiple insurances to resolve any unpaid balances. Assists patients/families with financial arrangements, including financial assistance, for qualified patients from outside agencies.
PRIMARY FUNCTIONS

  • Maintain and audit accounts receivables/credits over 45 days old monthly, documenting notes for productivity.
  • Work on 30 accounts per day or an average of 150 per week.
  • Communicate effectively with billing staff for improvements in billing primary and secondary claims.
  • Review insurance EOBs for potential processing errors.
  • Respond to denials and requests/correspondence within a two-day timeframe.
  • Ensure accurate designation of balances between insurance and patients.
  • Assist patients with inquiries over the phone or in person.
  • Respond to audits and regulatory inquiries.
  • Research credit balances for assigned insurances.
  • Educate other staff on assigned payers.
  • Serve as the representative for specific payers for the organization.
  • Answer patient questions regarding statements or billing inquiries.
  • Effective communications with other departments for timely corrections
  • Other duties as assignedEDUCATION AND EXPERIENCE
    • High school degree or GED;
    • One to three years data entry and billing and claims experience in healthcare setting or billing externship. Education or knowledge may be substituted for the experience requirement
    • Experience in a multispecialty clinic setting.PREFERRED LICENSE/CERIFICATIONS
      • Billing Certificate, the result of graduation from a certified billing school;
      • Coder and/or Billing Certificate may be substituted with demonstrated proficient knowledge of healthcare billing processes.KNOWLEDGE, SKILLS, AND ABILITIES
        • General knowledge of computerized practice management systems, preferably Cerner Electronic Health Record System.
        • Ability to learn billing and collection system within rural health facilities and critical access hospitals.
        • Ability to communicate with tact and diplomacy with diverse groups of people including staff, providers, and insurance companies on behalf of the organization.
        • Ability to display sensitivity to the patient population being served
        • Ability to work on a variety of assignments concurrently within established deadlines
        • Ability to work with others in a problem solving and team environment and to work alongside staff as needed
        • Knowledge of HIPAA as it relates to medical & behavioral health billing
        • Position requires a high level of accuracy and attention to detail
        • Ability to communicate effectively, both orally and in writing
        • Ability to respond effectively to sensitive inquiries or complaints
        • Ability to work independently with minimal supervision
        • Proficient with computers and MS Windows software programs
        • Knowledge of Federally Qualified Health Care billing and reimbursement preferred
        • Knowledge of Medicare and Medicaid guidelines
        • General knowledge of UB04, HCFA1500 Electronic and Paper claim formsADDITIONAL QUALIFICATIONS

        • Bilingual a plus (English / Spanish) preferred
        • Healthcare experience highly preferred
          RELATIONSHIP REPORTING

        • Reports to the PFS Director
          PHYSICAL REQUIREMENTS

        • Ability to sit, stand and or walk for extended periods of time
        • Ability to view a computer screen for extended periods of time
        • Ability to perform repetitive hand and wrist motions for extended periods of time




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