Opening: April 11, 2019
Closing: Open Until Filled
Wind River Family & Community Health Care is seeking applicants for the position of Medical Billing Specialist. Wind River Family & Community Health Care provides ambulatory health care for the service population of the Wind River Reservation. The Medical Billing Specialist serves as a member of the administrative staff of the ambulatory health care clinic located in Arapahoe, Wyoming.
The incumbent is responsible for accurate and timely preparation and submission of claims to third party carriers and Intermediaries while interacting with other departments and outside agencies.
Prepare and submit insurance claims to all third party payers for all patients who receive care from Wind River Family & Community Health Care facilities.
Review all health information systems (RPMS) and/or documentation to determine billable charges.
Reviews all claims before submission to insurance companies.
Maintains file system for billed claim records and backup for audit purposes. Verifies coverage and follows up on submitted claims.
Requests corrected diagnosis for reimbursement purposes from a variety of healthcare providers.
Process and manage the filing of medical billing claims for a variety of health related services (i.e., Medical, Dental, Behavioral Health, Chemical Dependency, Optometry, Pharmacy, Radiology, etc.)
Process billing claims with health carriers to include, Medicare and Medicaid, patient private insurance carriers, railroad, self-insured agencies, government agencies, etc.
Ensure timely billing of all health related health care service claims avoiding any delays in filing and correct any errors quickly to insure payment and/or to avoid non-payment.
Process medical claims daily utilizing carrier claim forms or electronic claim filing sources; accurately and in a timely manner.
Review daily status of account receivable accounts to identify and resolve billing and processing problems.
Ensures insurance payments are in alignment with fee schedules.
Conducts monthly audits of posted charges, payments and denials for corrective action.
Ensures comprehensive accounts receivable follow up is conducted
Identifies problem areas in denials and coding errors and prioritizes work lists/workflow.
Monitors the overall revenue cycle to ensure timely and accurate processing.
Understands and notes any write-off delinquent accounts ensuring third party payers are closely monitored.
Obtain all required documentation, process, and maintain to ensure that all health care provider billing documents with government and health insurance carriers are current to avoid delays in filing for medical service claims.
Initiates and answers pertinent correspondence.
Maintains required electronic and hardcopy financial records and files for audit purposes.
Shall embrace cultural differences and interact positively with internal staff as well as external contacts in a culturally competent and respectful manner.
Perform other duties as assigned.
Knowledge of and skill in applying an extensive body of Business Office rules and procedures concerning benefits programs such as Medicare/Medicaid, SSA, County DFS Offices, tribal programs and other related agencies to advocate for and assist patients in securing third party resources.
Knowledge of eligibility requirements for Medicare, Medicaid and SSI to assist patients in seeking benefits.
The ability and skill to interview patients in order to determine eligibility for alternate resources.
The ability and skill to compile and write reports from various documents maintained within the Business Office.
Must maintain strict and complete confidentiality of all administrative, medical and personnel records, and all other pertinent information that comes to his/her attention or knowledge.
Communication skills are required to effectively explain and solicit appropriate information from the patient.
Must have the ability to work under stressful situations and must be highly motivated to assist patients in applying for third party resources to insure that they get the highest possible quality of health care available.
Must have specialized training in Medical Claims processing, ICD-9/ICD-10 and CPT coding, medical terminology and be proficient with MS Office (Word, Excel, Power Point, Access), advanced Microsoft Excel and excellent with spreadsheet and RPMS billing software applications.
Minimum of (1) year of experience in medical billing office in a healthcare setting, which demonstrates expert knowledge of established professional medical billing processes, procedures and protocols.
Will possess a high degree of working knowledge and experience in RPMS 3P, A/R, Patient Registration, accounting reconciliation; medical service claims filings with a variety of health carriers, Medicare, Medicaid, both electronically and/or by paper.
The incumbent must maintain strict confidentially and high ethical standards in performing the position. The incumbent needs to be respectful, possess cultural awareness and sensitivity, be flexible, and demonstrate sound work ethics.
How to Apply:
Complete a Northern Arapaho Tribal application form and submit it to the Wind River Family and Community Health Care Human Resources Department at 511 N. 12th E. Riverton, WY or Northern Arapaho Human Resources program located at 533 Ethete Road, Ethete, WY.
For more information please call 307-856-9281 Ext 105 or 307-463-4473.