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Company: Wilson Health
Location: Sidney, OH
Career Level: Entry Level
Industries: Healthcare, Pharmaceutical, Biotech

Description

Wilson Health is looking for a direct hire Commercial Biller in our Patient Accounting Department at  Wilson Health for our location in Sidney, Ohio 

Key Perks and Benefits:
  • Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
  •   Generous paid time off (PTO) program beginning day one, designed to support work-life balance, rest, and time with family.
  •  Medical Insurance: Choose from two High Deductible Health Plan (HDHP) options or a PPO plan, along with Dental and Vision coverage. Benefits begin on the first of the month following your hire date.
  •  HSA with employer contribution for eligible health plans; FSA for medical and dependent care expenses.
  • Company-paid Life Insurance and Long-Term Disability Insurance
  • Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance.
  • Industry-leading retirement plan – employer contributions begin day one with no waiting period for participation.
  • Tuition Assistance Program
  • Free access to an on-site gym, available 24/7, making it easy to prioritize your health and wellness before or after your shift.
Employment Status: FULL TIME  - 40 hours per week - 80 hours per pay period  Shift: 1st shift Working HoursFLEXIBLE  between the hours of 6:30am and 5:30pm Position Reports to: Director of Revenue Integrity                    JOB SUMMARY: Under the directions of the Manager of Patient Accounts the Billing Specialist releases insurance claims electronically and mails hard copy UB/1500 claims as required, The Billing Specialist will follow up on unpaid claims which include all Non Medicare, Medicaid or B WC claims and rebill or Appeal claims as indicated   RESPONSIBILITES OF THE BILLING SPECIALIST:
  • Billing of Commercial Payers claims through Electronic Vendor (Quadax) which requires keeping up to date with Payer requirements and/or edits. 
  • Bills secondary, tertiary, etc. claims electronically or mails the UB/1500 with EOB as required by Payer.
  • Works closely with all departments throughout the hospital regarding charges and/or late charges.
  • Responsible for follow-up of all Commercial Payers
  • Works the 30 day and out worklist in Meditech and contacts Payers via phone or Payer web site regarding no pays.
  • Makes contact with the patient and/or guarantor when necessary to secure payment
  • Appeals claims on behalf of the patient to secure payment or if a claim has been denied for inappropriate reasons. Biller also follows up on the Appeal.
  • Works mail as it applies to the Commercial Biller to secure payment
  • Works closely with Central Scheduling/Registration and Medical Records regarding Denials for No Authorizations and/or Medical Necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal.
  • Works Cash Report daily to ensure proper payment from Payers and makes appropriate adjustments as required,
  • Receives phone calls from patients and/or guarantor regarding account balances, itemized bill or Explanation of Benefits.
  QUALIFICATIONS REQUIREMENTS:
  • Six years previous hospital billing experience.
  • Medical terminology and understanding of CPT and ICD 10 codes
  • Electronic Health Records (EHR) - EPIC experience preferred,
EDUCATION and/or EXPERIENCE: High school diploma or general education degree (GED) and minimum of six year experience and/or training; or equivalent combination of education and experience as a Hospital Commercial Biller.    LANGUAGE SKILLS: Ability to read and comprehend simple instructions, short correspondence and memos. Ability to write simple correspondence. Ability to effectively present information in one on-one and small group situations to customers, clients and other employees of the origination.   OTHER SKILLS and ABILITIES;
  • Accurate typing skills, computer keyboard skills and data entry. Knowledge of medical terminology, CPT and HCPCS codes.
  • Calculator skills.
  • Ability to work in a highly stressful environment. Ability to adapt to change. Knowledge of Excel. Organization and prioritizing skills.
  • Ability to communicate with co-workers.
  PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job, Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is occasionally required to walk.   The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.   WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while preforming the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.   Mission & Vision & Values:
  • Improve the health and wellness of the community by delivering compassionate, quality care.
  • Be a trusted, nationally-recognized leader of innovative, collaborative, community health.
  • A.S.P.I.R.E - Always serve with professionalism, integrity, respect, and excellence.
EOE (Equal Opportunity Employer)                            


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