Institutional & Profee Claims Biller - Medicaid

The ***Institutional \& Profee Claims Biller*** is responsible for providing full\-cycle claims submission and follow\-up/denial efforts . This includes coordinating the day to day activities of a hospital's or clinic’s business office such as patient billing and collection, third\-party payer relations, and/or preparation of insurance claims. Working claims **AND** denial que's is part of this persons day\-to\-day responsibilities. **Essential Functions:** In addition to working as prescribed in our Performance Factors specific responsibilities of this role include: * Coordinates business office functions and personnel that may include, but is not limited to patient billing, credit and collections, and data entry. * Recommends new processes and changes in current processes. * Implements controls to ensure appropriate submission, billing and credit and collections are kept in accordance with established procedures * Implements appropriate procedures for follow\-up on third party approvals, billing, and collection of overdue accounts * Ensures that accurate and timely billing is being done by staff members in accordance with established procedures and third\-party requirements * 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 * Responsible for assisting manager in the management of employees which would include coaching, training and performing necessary disciplinary actions including following up on action plans for their employees. * Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer * Ensures employee compliance with dress code, attendance and other company policies. * Processes miscellaneous paperwork and performs other administrative duties as assigned. **Minimum Requirements:** Education/Experience/Certification Requirements * **At least 5 years hospital billing experience, to include; Charge Entry, Claim Review (prior to submission), Claim Submission, Claim Denials, Claim Re\-Submission** * Experience processing Institutional and Profee claims is **REQUIRED** * Experience processing Medicaid claims is ideal * Excellent communication (written and oral) and interpersonal skills. * Strong organizational, multi\-tasking, and time\-management skills. * Must be detail oriented and able to follow through on issues to resolution. * Must be able to act both independently and as a team member. * High School Diploma or equivalent combination of education and relevant experie