Biller / Collector

Company: Cibola General Hospital
Location: Grants
Posted on: April 1, 2025

Job Description:

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
        
        
        
        
        PIaaf0c85eeeb8-37248-34121374

Keywords: Cibola General Hospital, Rio Rancho , Biller / Collector, Other , Grants, New Mexico