CCMC Biller (Patient Account Rep) at Portland, OR (Downtown) – Portland, Oregon

• Billing to all non-government payors (to include medical insurers, auto insurers, workers compensation insurers, managed care contracts, special grants, government agencies)
  • Prepare timely and accurate on-line and paper claims (UB-04’s, 1500’s, and dental bills) to third party payors. Research any missing or incorrect data using Document Imaging, LCR, PMS, and Signature. Request copies of medical records, as necessary. Review all claims for electronic edits (to include CPT, HCPC’S, and ICD- 10 coding) and accuracy and make corrections as appropriate. Inpatient, inpatient interims, and outpatient bills over $500 are to be mailed same day as printed. Outpatient claims under $500 must be billed within 5 days of printing or be documented as to delay and resolution.
  • Document the billing on all inpatient, day surgery, observation, and ed cases.
  • Process up front contractual allowances using cheat sheets, contracts, and Ascent.
  • Bill secondary payors using the different rules for COB as dictated by state regulations and contractual agreements.
  • Prepare special billing documents as needed by agencies.
  • Document all non-covered services forms.
  • Complete all work following HIPAA regulations
  • Review web-based eligibility systems (USSP, ODS Benefits Tracker, etc.) to confirm eligibility and correct insurance plan coding. Update accounts, as necessary.

• Third party follow-up and collection:

  • Review previous admissions/accounts and/or making phone calls to verify the validity of the insurance plan code.

  • Review claims that are returned due to incomplete or incorrect addresses

• Other duties as assigned within the scope of the established class specs. To also include activities that are classified as team support and environmental activities

• Recent (within one year of date of hire) Microsoft Office Suite experience in Windows environment with skill in document production using WORD, spreadsheet construction in EXCEL.
• Experience in billing Hospital claims or UB-04 claims.
• Knowledge of and experience in interpreting managed care contracts.
• Familiarity with DRG, CPT, HCPC and ICD-10 coding

Job Related Knowledge, Skills and Abilities (Competencies):

• Typing 45 wpm
• Ability to use multiple system applications
• Demonstrated ability to communicate effectively verbally or in writing.
• Demonstrated ability to process detail oriented and analytical work.
• Demonstrated ability to prioritize and accomplish multiple tasks in a fast-paced environment; consistently adhering to defined due date