Total 3 health instructor job vacancies in Finance / Banking / Insurance category in Abbott Northwestern Hospital

Approved Remote States

1.     Arizona

2.      Florida

3.      Georgia

4.      Idaho

5.      Indiana

6.      Iowa

7.      Maine

8.      Michigan

9.      South Dakota

10.   Texas

11.   South Carolina

12.  North Dakota

13.   Wisconsin

14.   Tennessee

Position Summary: 

The Insurance Billing Specialist’s main focus is to obtain maximum and appropriate reimbursement for Bozeman Health and all related entities,  hospital (HB) and/or professional (PB) claims from third party payers.  Supports the timely development and accurate submission of claims to third party payers to include insurance follow-up related to no response, returned claims, denied claims, or claim edits preventing claim submission, submitting corrected or replacement claims, and combining hospital accounts in accordance with payer billing policies.   Monitor, resolve or escalate payer denials, returned claims, claim edits, correspondence and report payer claim processing behavior to assist with identifying systemic issues that may require process improvement to strengthen the health of the Revenue Cycle as well escalating identified concerns to the HB or PB Supervisor.   Collaborate and coordinate with other Revenue Cycle functions or departments to resolve DNBs, claim edits, denials that are preventing  timely claim submission or appropriate reimbursement.  Prioritizes and completes accounts routed to billing WQs to reduce accounts receivable days and escalates high-dollar accounts or systemic issues to either the HB or PB Billing supervisor for resolution.   

Minimum Qualifications:

• High School Diploma or Equivalent
• One (1) year of general or medical office experience
• Preferred: Epic experience
• Preferred: Completion of program in medical billing degree or certification program
• Preferred: Two (2) years of healthcare hospital and/or professional billing experience

Essential Job Functions:

• Submits timely and accurate claims to primary, secondary, and tertiary insurances for both electronic and paper submission
• Follows up on applicable No Response WQs and Rejected Claims WQs through phone contact or written correspondence to ensure that no account reaches 180 days old from discharge date and still due by insurance, regardless of dollar amount
• Reviews accounts by verifying that reimbursement amounts are appropriate, coordination of refunds, if appropriate, and submitting adjustments for approval when necessary, routes claims for appeal, resubmits claims, or moves balances from insurance responsibility to patient responsibility when appropriate
• Ensures that claims have appropriate information on them for submission to insurance companies or agencies by reviewing claim edit WQs and other prebilling insurance WQs and escalates systemic issues identified to supervisor
• Assists Customer Service with claim processing questions
• Identifies and escalates concerns regarding claim processing to Billing Supervisor

Knowledge, Skills and Abilities

• Demonstrates sound judgment, patience, and maintains a professional demeanor at all times
• Exercises tact, discretion, sensitivity, and maintains confidentiality
• Performs essential job functions successfully in a busy and stressful environment
• Learns current and new computer applications and office equipment utilized at Bozeman Health
• Strong interpersonal, verbal, and written communication skills
• Analyzes, organizes, and prioritizes work while meeting multiple deadlines
• Works varied shifts as scheduled and/or needed

Approved Remote States

1.     Arizona

2.      Florida

3.      Georgia

4.      Idaho

5.      Indiana

6.      Iowa

7.      Maine

8.      Michigan

9.      South Dakota

10.   Texas

11.   South Carolina

12.  North Dakota

13.   Wisconsin

14.   Tennessee

Position Summary: 

The Hospital / Professional Insurance Billing Supervisor is responsible for assisting with planning, directing, organizing, monitoring and staffing departmental services subject to policies, budgets, objectives and directives mandated by regulatory agencies, DNV and the hospital executive team in collaboration with the Patient Financial Services (PFS) manager. Oversees and coordinates the insurance billing function for Bozeman Health and all related entities, to include insurance follow-up related to no response, returned claims, denied claims, or claim edits preventing claim submission. Supports billing staff in maintaining team discipline to support the accurate and timely claims development and submission to payers to maximize reimbursement for the system. Conducts training and education for all billing functions to prevent and mitigate returned claims or claims denied due to lack of timely response or timely filing requirements.  Collaborate and coordinate with other Revenue Cycle functions or departments to resolve discharged not billed (DNB) or claim edits that are preventing timely claim submission.  Monitor denials, returned claims, claim edits, and payer claim processing behavior to assist with identifying systemic issues that may require process improvement to strengthen the health of the Revenue Cycle as well escalating identified concerns to the PFS manager.   

Minimum Qualifications:

• Associate's degree in Business or Accounting; an equivalent combination of education and experience will be considered
• Three (3) years of experience in a medical billings and claims
• Three (3) years of supervisory experience
• Prior experience with Epic billing

• Prior experience in healthcare administration, revenue cycle, or accounts receivable management
• Knowledge of electronic healthcare payment transactions
• Regulatory knowledge required for PPS and CAH Hospital, Provider-Based, Free-Standing Clinic, and Swing Bed Billing
• Preferred: Bachelor’s degree in business or related field

Essential Job Functions:

• Assists department leadership with broad operations to ensure the provision of comprehensive departmental services in compliance with all regulatory agencies and hospital requirements
• Ensures a collaborative departmental approach to long-range strategic operational planning, care and service design and development of organizational policies, which reflect the mission of the organization
• Coordinates and oversees the organization-wide departmental services.  Continuously assesses, measures and improves departmental performance utilizing key performance indicators. Helps plan initiatives to increase performance as needed
• Demonstrates responsible management of all departmental resources
• Monitors quality and productivity levels for all billing staff members
• Manages WQ assignments in Epic and ensures accounts are not left unworked
• Demonstrates clinical/technical and supervisor competency.  Ensures staff professional needs are met
• Leads, teaches, inspires, helps and consistently demonstrates hospital behavioral standards
• Analyzes data and prepares reports on performance as required or requested
• Reviews denial and underpayment trends in collaboration with PFS Manager, Contract Specialist, and Compliance as appropriate and follow up staff to develop improvement initiatives; communicated with payers to resolve issues and foster working relationships
• Identifies payer trends and communicates with PFS Manager for escalation
• Ensures timely billing and proactively investigates and addresses potential billing process inefficiencies
• Approves appropriate account adjustments within identified thresholds and ensures PFS Manager is aware of trends in adjustment spaces (timely filing etc.)
• Oversees recruiting, hiring, and training practices; monitors and provides performance evaluations for billing staff
• Works with external resources as appropriate and brings issues that arise to the PFS Manager

Knowledge, Skills and Abilities

• Strong leadership managerial skills; ability to plan, delegate, train, monitor and improve work performance
• Demonstrates ability to lead to and motivate staff
• Demonstrates sound judgement, patience, and maintains a professional demeanor at all times
• Ability to work in a busy and stressful environment
• Familiar with business and medical terminology, billing codes, and coding systems (ICD-10, HCPCS, CPT)
• Strong interpersonal, organizational, multi-tasking, verbal and written communication skills
• Creativity, problem analysis and decision making
• Exercises tact, discretion, sensitivity and maintains confidentiality

• Detail oriented, organizational skills and the ability to prioritize
• Standard office equipment and computer applications; MS Office, internet applications and proficient in Epic.
• Ability to work varied shifts

Current Employees:

If you are a current employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Starting Pay Rate Range

to

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)

*Flexible scheduling

Job Description

Essential Functions:

• Conducts timely follow up of claims as needed.
• Demonstrates application of compliance standards and payer specific data to properly file claims, 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 payor procedures including, but not limited to; Medicare, Medicaid, Champus, Blue Cross and all other third party contractual agreements entered into.
• Uses 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 payor 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.
• All other duties as assigned.

Additional Requirements

Preferred:
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 professionals

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Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.