Performs full-cycle claims billing and denial management for critical access hospitals and rural health clinics. Coordinates patient billing, collections, third-party payer relations, claim submissions, follow-up, quality assurance, and business office procedures. Supports employee coaching, training, compliance, customer service, administrative duties, and process improvements while protecting confidential patient information.
The Full-Cycle Biller is responsible for providing TruBridge claims processing services to Critical Access Hospital (UB-04) and Rural Health Clinic (CMS-1500) facilities in New Hampshire. This includes coordinating the day to day activities of a hospital's or clinic’s business office such as patient billing and collection, third-party payer relations, and/or preparation of insurance claims.
Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
- Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry.
- Recommends new processes and changes in current processes.
- Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures
- Implements appropriate procedures for follow-up on third party approvals, billing, and collection of overdue accounts
- Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third-party requirements
- Responsible for consistently meeting production and quality assurance standards
- Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
- Updates job knowledge by participating in company offered education opportunities
- Protects customer information by keeping all information confidential
- Processes miscellaneous paperwork
- Ability to work with high profile customers with difficult processes
- May regularly be asked to help with team projects
- Responsible for assisting manager in the management of employees which would include coaching, training and performing necessary disciplinary actions including following up on action plans for their employees.
- Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
- Ensures employee compliance with dress code, attendance and other company policies.
- Processes miscellaneous paperwork and performs other administrative duties as assigned.
Minimum Requirements:
Education/Experience/Certification Requirements
- At least 3-5 years Full-Cycle billing experience, can include Acute Hospital and/or Physician (Profee) claims
- Experience with Claims and Denial Que's
- Familiar with Commercial and Medicaid claims REQUIRED
- Strong organizational, multi-tasking, and time-management skills.
- Must be detail oriented and able to follow through on issues to resolution.
- Must be able to act both independently and as a team member.
- High School Diploma or equivalent combination of education and relevant experience needed.
- Excellent critical thinking, organizational, and time management sills with a strong attention to detail, accuracy, and follow through
Why join our team?
- Work remotely with a work/life balance approach
- Robust benefits offering, including 401(k)
- Generous time off allotments
- 10 paid holidays annually
- Employer-paid short term disability and life insurance
- Paid Parental Leave
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