Description

Join the team that delivers a Healthier Bottom Line. Our purpose at InlandRCM is to strengthen rural hospitals by providing dependable, all-American revenue cycle expertise that sustains access to quality healthcare in rural communities.

 The Hospital Biller I is a Full Time, Regular position working in several hospital client EMRs such as Epic, Cerner and Meditech Expanse. Hands-on experience in at least one of these hospital EMRs is required, with experience in multiple systems preferred but not required. This position is remote Monday-Friday day shift. This role requires the ability to work efficiently within the EMR to review claim and patient information, identify and resolve claim edits and denials, and follow up directly with insurance payers as needed, while managing work across multiple client accounts in a typical day. Detailed billing and denial scenarios will be discussed during interviews to confirm hands-on practical experience working directly in Epic, Cerner or Meditech Expanse.

Summary: Address large volume of unpaid or incorrectly paid/denied claims to secure reimbursement.

General Description: Performs end-to-end medical billing functions for institutional and professional claims, including claim review, edit and denial resolution, corrected claim resubmission, payer follow up, and resolution of overpayments or credit balances. This role requires experience managing claims through the full lifecycle rather than a single, segmented billing function.

Essential Duties/Responsibilities: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Responsible for all phases of billing to government and commercial insurers, including initial billing of clean claims electronically or on paper, subsequent follow up on unpaid claims to the point of payment or resolution of the claim, and resolving credit balances. (Inclusive of Medicare).
• Prioritizes assigned worklist of aged accounts appropriately and works on aging accounts to their resolution.
• Reviews and processes electronic claims, claim edits and deletions appropriately and compliantly.
• Interprets billing regulations accurately and within federal, state, and third-party billing regulations and policies.
• Utilizes various client host systems to research and rebill claims.
• Other special projects and duties as assigned.

General Duties and Responsibilities:

• Ability to maintain strict confidentiality within the Inland Imaging companies and Inland’s customers.
• Follows all Health and Safety policies and guidelines of Inland Imaging.
• Follows all company policies including those regarding harassment, non-retaliation, discrimination, respectful workplace, and related policies.
• Follows all policies regarding HIPAA, non-disclosure of confidential information and company security.
• Honest, pleasant manner and good personal hygiene.
• Free of alcohol and drug abuse.
• Excellent communication and interpersonal skills.
• Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.
• Ability to consider individual needs in communication with and assessment and treatment of patients of all ages.
• Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
• Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smoothly functioning department.
• Performs other duties as required by displaying team spirit and self-growth, accepting, and performing other projects and responsibilities, and requesting other projects and responsibilities.
• Attendance is a requirement for this position.
• Performs other special projects and duties as assigned.

Supervisory Responsibilities: There is little or no supervisory responsibility in this position

Advocacy: 1. Treats all clients with dignity and respect 2. Provides excellent customer service 3. Conforms to Joint Commission and HIPAA regulations 4. Complies with PHI (Protected Health Information) 5. Demonstrates the InlandRCM Core Values:

Diligence in Execution, Comprehensive Customer Care, Perseverance in Solution Finding, and a Growth Mindset

Requirements

Qualifications:

• Education: High School Diploma/GED required.
• 2 years’ experience with either EPIC, Cerner or Meditech Expanse
• Two-year medical billing course successful completion is desired.
• Working knowledge of government hospital payment methodologies including OPPS, Critical Access Hospital method II, or both preferred.
• CPT, HCPCs and ICD-10 coding experience preferred.
• Experience with electronic claims scrubbing and clearinghouse systems preferred.
• Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults
• To comply with provisions, set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of InlandRCM will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG). Employees must not be included on this list.
• Licensure: N/A
• Certifications preferred: One certification from an industry recognized healthcare accrediting body at the start of the job or obtain it within 6 months of starting job.
• Candidates must have hands-on experience in at least one hospital EMR. Experience across multiple systems is a plus.
• Computer Skills: Experience with Epic software required. Experience with the following computer applications is highly desired: Microsoft Office products (Outlook, Word, Excel), Internet, Intranet, Meditech or other hospital or physician EHR/accounting system.
• Remote Work Capability. Ability to work from a remote (home) based environment if requested. Need to have a dedicated workspace with desk, desk chair, and access to cable internet.
• Background Check:
• Drug Test: Eligible employees must be able to pass a post-offer, pre-employment drug test. InlandRCM is an EEO employer.