Commercial biller (Epic experience required; remote option) (pullmanregionalhospital)

Job Description

Pay Range:

The base pay range for this position is

however, base pay offered may vary depending on job-related knowledge, skills, and experience.

Job Title: Biller-Commercial

Department: Patient Financial Services                 JOB IS FROM: partimejobs.netVIEW

Reports to: Director of Patient Financial Services

Classification: Hourly

Position Overview:

We are seeking a detail-oriented and experienced Commercial Biller to join our team. The ideal candidate will possess a strong understanding of Revenue Cycle Management processes, with specific expertise in handling denials, rejections, underpayments and appeals.

Required Education, Licensure, Certifications, & Experience:

• High school diploma or equivalent.
• 6 years of current experience in claims processing and denials management.
• 3 years of current EPIC experience required
• Recent experience working with EPIC EMR system.

Preferred Education, Certifications, & Experience:

• Bachelor’s degree.
• CPC, CRCR, or CPMA certifications.

Essential Functions:

Working knowledge of both hospital and physician denials and underpayments

Identify trends in denials and implement solutions in line with payer requirements to reduce future denials and optimize collections.

Stay current with changes in commercial payer policies, regulatory guidelines, and industry standards, implementing these updates into daily billing practices.

• Analyze denials and determine the appropriate course of action for appeal or resubmission.
• Prepare and submit appeals for denied claims, ensuring accuracy and compliance with regulatory requirements.
• Collaborate with internal teams, including billing, coding, and clinical staff, to gather necessary information for appeals and resolve denial issues efficiently.
• Maintain detailed records of denial cases, including appeals filed, communications with insurance representatives, and any additional documentation required.
• Monitor the status of appealed claims and follow up with insurance representatives as needed to expedite resolution.
• Generate and analyze reports on denials trends, identify root causes, and make recommendations for process improvements.

Non-Essential Functions:

• Any other duties as needed to drive towards the vision, fulfil the mission, and abide by the values of the organization.

Required Skills:

• Ability to analyze denial reasons, identify trends, and develop strategies for minimizing denials.
• Excellent written and verbal communication skills, with the ability to effectively communicate with internal staff and insurance representatives.
• Strong attention to detail and accuracy in documentation and appeals submissions.
• Ability to collaborate effectively with multidisciplinary teams to achieve common goals.
• Thorough understanding of billing regulations, coverage guidelines, and appeals process.

Physical Requirements:

• Sitting:  90%.   Standing/Walking:  10%
• Occasional lifting/carrying of supplies and paper weighing up to 40 pounds.
• Occasional pushing/pulling to move supplies and equipment.
• Occasional climbing of stairs to reach other levels of the building.
• Occasional stooping/kneeling/bending/crouching to file in low cabinets, purge old bills and to print forms.
• Occasional reaching/handling/fingering to complete paperwork, use computers, file, and answer telephones.
• Frequent talking/hearing/seeing to interact with staff and customers to complete assigned tasks.

Environmental Conditions: Inside

Location: Onsite or Remote

• Occasional exposure to noise from printers, telephones and fax machines.
• Minimal risk of injury due to proximity of moving parts on computer printer, typewriter, and copier.
• Minimal exposure to fumes and caustic materials from copy machine toner and cleaning supplies.
• Minimal exposure to biohazardous materials. 

Travel Requirements:

If not in the Palouse area, will need to travel to Pullman for New Employee Orientation week

Company Perks:

Our employees are our most important asset and that’s reflected in our benefits. Pullman Regional is proud to offer a variety of benefits to support employees and their families, including:

• Medical/Vision, Dental, Health Savings Account, and Paid Leave Time
• Employer Paid Life Insurance and Long-Term Disability
• Retirement with Employer Matching Contributions
• Voluntary Benefits that include: Life Insurance, Critical Illness, Accident Insurance, and Short-Term Disability
• Services Discount and EAP Resources

A Few More Important Points:

The job posting highlights the most critical responsibilities and requirements of the job. It is not all-inclusive. There may be additional duties, responsibilities, and qualifications for this job.

Disability Contacts:

Applicants with disabilities who require assistance or accommodation should contact Human Resources at humanresources@pullmanregional.org

Current Pullman Regional Employees:

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