Individual Contributor
PB Epic Claim Processor
Location
United States
Posted
101 days ago
Salary
0
Seniority
Mid Level
No structured requirement data.
Job Description
PB Epic Claim Processor
CPSI
The PB Epic Claim Processor position is responsible for acting as a liaison for hospitals and clinics using TruBridge’s complete business office services. They work closely with TruBridge management and hospital employees to bill insurance companies for all hospital, hospital-based physician and clinic bills. They pursue collection of all claims until payment is made by insurance companies; and perform other work associated with the billing process. Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include: - Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing. - Secures needed medical documentation required or requested by third party insurances. - Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains. - Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers. - 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. - Ensure all claims are submitted daily with a goal of zero errors. - Timely follow up on insurance claim status. - Reading and interpreting an EOB (Explanation of Benefits). - Respond to inquiries by insurance companies. - Denial Management. - Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles. - Review late charge reports and file corrected claims or write off charges as per client policy. - Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy. - Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer. Minimum Requirements: Education/Experience/Certification Requirements - 3 years of recent Critical Access or Acute Care facility and professional claim billing - PB Epic E.H.R Experience Required. - FULL Cycle RCM Experience Required. - Computer skills. - Experience in CPT and ICD-10 coding. - Familiarity with medical terminology. - Ability to communicate with various insurance payers. - Experience in filing claim appeals with insurance companies to ensure maximum reimbursement. - Responsible use of confidential information. - Strong written and verbal skills. - Ability to multi-task. Business Support
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