Nebraska Methodist Health System
Job Overview
Title:
Patient Billing Rep I
Employer:
Nebraska Methodist Health System
Location: Methodist Corporate Office, 825 S 169th St., Omaha, NE
Schedule: Mon – Fri, 8‑hour shifts, flexible between 6:00 am and 6:00 pm
Core responsibility: billing, electronic claim submission, follow‑up, and collections of patient accounts.
Responsibilities
Electronic and Hardcopy Billing
Submit all EDI and paper claims as required by departmental and payer guidelines.
Obtain appropriate EOBs using health system resources.
Review Billing Scrubber Claim Detail Screens to ensure accurate data for submission.
Correct claim issues identified in the billing scrubber and document updates in the Source System.
Prepare secondary and tertiary billings, both manually and electronically, on UB‑04s and/or CMS‑1500s.
Submit adjusted UB‑04/837I and/or CMS1500/837P claims following departmental and payer guidelines.
Display Effective Communication Skills
Demonstrate active listening skills.
Notify leaders and supervisors of identified issues.
Follow telephone etiquette procedures established by the organization.
Respond professionally and courteously to customers, health system staff, and management.
Handling of Referrals
Timely and accurate handling of referrals, including escalated priorities, per departmental guidelines.
Document all referrals clearly and appropriately in the Source System.
Follow up with patients on the final results of inquiries and communicate outcomes professionally.
Knowledge of System Applications
Maintain proficiency with current health system applications.
Identify, obtain, and print medical records as needed for denial resolution or system edits.
Auditing of Patient Accounts
Apply accounting and business principles to determine remaining balances on encounters.
Update proration to allocate dollars to appropriate benefit orders accurately.
Use available resources to complete account audits.
Document audit findings and actions taken in the Source System.
Claim Follow‑Up with Third‑Party Payers
Understand third‑party billing and follow‑up processes per department specifications.
Grasp contract‑related requirements.
Leverage payer websites and tools to expedite follow‑up.
Ensure appropriate documentation in the Source System.
Interpret correspondence accurately for handling.
Special Projects and Tasks as Assigned
Complete assigned projects on time, accurately, and per leadership specifications.
Handle daily, weekly, and monthly assignments accurately and promptly.
Maintaining Daily Workflow
Manage and maintain workflow queues according to departmental guidelines.
Process mail and correspondence per guidelines.
Document tasks in the Source System with proper methods.
Understand various work item, state‑based, and exception queues in the Patient Accounting System applications.
Education
High school diploma, General Educational Development (GED), or equivalent required.
Coursework in Coding, Billing, or Healthcare Management, preferably through a secondary education institution or online classes via AHIMA.
Experience
Minimum of one (1) year of experience in healthcare third‑party billing and/or claims processing preferred.
Prior exposure to UP04 and/or CMS1500 claim data through work in a physician’s office or other healthcare setting preferred.
Certifications
N/A
Skills, Knowledge, and Abilities
Interpret UB‑04 and/or CMS1500 claim data to troubleshoot claim edits and meet payer billing requirements accurately.
Create and submit original and corrected claims.
Audit accounts and payer explanations of benefits (EOBs) to determine appropriate actions.
Use effective communication skills to handle patient inquiries, attorneys, health system staff, and payers professionally.
Apply accounting and business principles for accurate auditing of patient accounts.
Follow up with third‑party payers on claims and appeals to ensure timely and accurate processing.
Maintain a working knowledge of multiple system applications.
Physical Requirements
Light work: Exert up to 20 pounds of force.
Physical Activity
Occasionally performed (1%–33%): Balancing, climbing, carrying, crawling, crouching, distinguishing colors, kneeling, lifting, pulling/pushing, reaching, standing, stooping/bending, twisting, walking.
Frequently performed (34%–66%): Hearing, repetitive motions, seeing/visual, speaking/talking.
Constantly performed (67%–100%): Fingering/touching, grasping, keyboarding/typing, sitting.
Job Hazards
Not related: Biological agents (primary airborne and bloodborne viruses), physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps), equipment/machinery/tools, explosives, electrical shock/static, radiation (alpha, beta, gamma, non‑ionizing).
Rare (1%–33%): Chemical agents (toxic, corrosive, flammable, latex), mechanical moving parts/vibrations.
About Nebraska Methodist Health System Nebraska Methodist Health System consists of four hospitals in Nebraska and southwest Iowa, over 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility.
Established in 1891, the organization prioritizes service to its communities, financial assistance, health education, outreach to diverse populations, and other community benefit activities.
It is an affirmative action/equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by federal, state or local law.
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Patient Billing Rep I
Employer:
Nebraska Methodist Health System
Location: Methodist Corporate Office, 825 S 169th St., Omaha, NE
Schedule: Mon – Fri, 8‑hour shifts, flexible between 6:00 am and 6:00 pm
Core responsibility: billing, electronic claim submission, follow‑up, and collections of patient accounts.
Responsibilities
Electronic and Hardcopy Billing
Submit all EDI and paper claims as required by departmental and payer guidelines.
Obtain appropriate EOBs using health system resources.
Review Billing Scrubber Claim Detail Screens to ensure accurate data for submission.
Correct claim issues identified in the billing scrubber and document updates in the Source System.
Prepare secondary and tertiary billings, both manually and electronically, on UB‑04s and/or CMS‑1500s.
Submit adjusted UB‑04/837I and/or CMS1500/837P claims following departmental and payer guidelines.
Display Effective Communication Skills
Demonstrate active listening skills.
Notify leaders and supervisors of identified issues.
Follow telephone etiquette procedures established by the organization.
Respond professionally and courteously to customers, health system staff, and management.
Handling of Referrals
Timely and accurate handling of referrals, including escalated priorities, per departmental guidelines.
Document all referrals clearly and appropriately in the Source System.
Follow up with patients on the final results of inquiries and communicate outcomes professionally.
Knowledge of System Applications
Maintain proficiency with current health system applications.
Identify, obtain, and print medical records as needed for denial resolution or system edits.
Auditing of Patient Accounts
Apply accounting and business principles to determine remaining balances on encounters.
Update proration to allocate dollars to appropriate benefit orders accurately.
Use available resources to complete account audits.
Document audit findings and actions taken in the Source System.
Claim Follow‑Up with Third‑Party Payers
Understand third‑party billing and follow‑up processes per department specifications.
Grasp contract‑related requirements.
Leverage payer websites and tools to expedite follow‑up.
Ensure appropriate documentation in the Source System.
Interpret correspondence accurately for handling.
Special Projects and Tasks as Assigned
Complete assigned projects on time, accurately, and per leadership specifications.
Handle daily, weekly, and monthly assignments accurately and promptly.
Maintaining Daily Workflow
Manage and maintain workflow queues according to departmental guidelines.
Process mail and correspondence per guidelines.
Document tasks in the Source System with proper methods.
Understand various work item, state‑based, and exception queues in the Patient Accounting System applications.
Education
High school diploma, General Educational Development (GED), or equivalent required.
Coursework in Coding, Billing, or Healthcare Management, preferably through a secondary education institution or online classes via AHIMA.
Experience
Minimum of one (1) year of experience in healthcare third‑party billing and/or claims processing preferred.
Prior exposure to UP04 and/or CMS1500 claim data through work in a physician’s office or other healthcare setting preferred.
Certifications
N/A
Skills, Knowledge, and Abilities
Interpret UB‑04 and/or CMS1500 claim data to troubleshoot claim edits and meet payer billing requirements accurately.
Create and submit original and corrected claims.
Audit accounts and payer explanations of benefits (EOBs) to determine appropriate actions.
Use effective communication skills to handle patient inquiries, attorneys, health system staff, and payers professionally.
Apply accounting and business principles for accurate auditing of patient accounts.
Follow up with third‑party payers on claims and appeals to ensure timely and accurate processing.
Maintain a working knowledge of multiple system applications.
Physical Requirements
Light work: Exert up to 20 pounds of force.
Physical Activity
Occasionally performed (1%–33%): Balancing, climbing, carrying, crawling, crouching, distinguishing colors, kneeling, lifting, pulling/pushing, reaching, standing, stooping/bending, twisting, walking.
Frequently performed (34%–66%): Hearing, repetitive motions, seeing/visual, speaking/talking.
Constantly performed (67%–100%): Fingering/touching, grasping, keyboarding/typing, sitting.
Job Hazards
Not related: Biological agents (primary airborne and bloodborne viruses), physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps), equipment/machinery/tools, explosives, electrical shock/static, radiation (alpha, beta, gamma, non‑ionizing).
Rare (1%–33%): Chemical agents (toxic, corrosive, flammable, latex), mechanical moving parts/vibrations.
About Nebraska Methodist Health System Nebraska Methodist Health System consists of four hospitals in Nebraska and southwest Iowa, over 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility.
Established in 1891, the organization prioritizes service to its communities, financial assistance, health education, outreach to diverse populations, and other community benefit activities.
It is an affirmative action/equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by federal, state or local law.
#J-18808-Ljbffr