About this opportunity
Monument Health lists this Biller I | Home Plus Pharmacy opportunity in rapid city, South Dakota. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Claims ProcessorPerform duties necessary to ensure the proper interpretation, processing, recording, approval and payment of inpatient and outpatient medical claims. Accurately reviews information for processing claims into a computerized system in accordance with the primary payer specifications and billing guidelines.Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:Supportive work cultureMedical, Vision and Dental CoverageRetirement Plans, Health Savings Account, and Flexible Spending AccountInstant pay is available for qualifying positionsPaid Time Off Accrual BankOpportunities for growth and advancementTuition assistance/reimbursementExcellent pay differentials on qualifying positionsFlexible schedulingEssential Functions:Demonstrates application of compliance standards and payer specific data to properly file claims and ensures prompt, appropriate reimbursement of services and supplies billed to third parties and appropriate payment of services and supplies due from patients, as evidenced by documentation, observation and feedback.Demonstrates a working knowledge of third party payer procedures including, but not limited to: Commercial Payers, Veterans Administration, worker’ compensation, third-party liability, county payers, and all other third party contractual agreements as required.Conducts timely follow up of claims. Use tools provided to track and trend patterns of claim submission issues that might require Compliance and Charge master staff to resolve, or HIPAA transaction code set review. Research payer requirements and offer suggestions to leadership for claims submission issues.Maintains and updates appropriate system documentation to provide information regarding claim processing to internal or external customers.Identifies unresolved requests of patient responsibility and transfers account to self pay. Performs duties and provides best customer service using behaviors that demonstrate responsibility and accountability.Participates in departmental activities related to performance improvement and quality control.Demonstrates a working knowledge of denial follow up and first level appeals.All other duties as assigned.Additional Requirements:Required: Education - High School Diploma/GED Equivalent in General StudiesPreferred: Experience - 1+ years of Clerical Experience; 1+ years of Medical Patient Accounts/Financial Services Experience Education - Bachelors degree in Accounting, Business, Health Related Field Certifications - Certified Clinical Account Technician (CCAT) - Accredited University or accredited training professionals; Certified Patient Account Technician (CPAT) - Accredited University or accredited training professionalsSedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.Job Category: FinanceJob Family: Insurance Services
Worksite address
rapid city, SD, 57701, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.