Covenant HealthCare Job - 41347722 | CareerArc
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Company: Covenant HealthCare
Location: Saginaw, MI
Career Level: Entry Level
Industries: Healthcare, Pharmaceutical, Biotech


Covenant HealthCare





The Biller demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant and the commitment to Keeping our Promise of Caring. Responsible for prompt and accurate billing and follow-up for all hospital and related professional services provided to patients covered by third party payers, including: Medicare, Medicaid, Blue Cross, Commercial, Workers Compensation and all Managed Care Programs. Responsible to secure timely and accurate reimbursement from third party payers and patients based on appropriate billing and follow up activities.


Contributes to organization success targets from patient satisfactions and net operating margin
Resolves patient billing inquiries and problems, follows up on balances due from insurance companies and patients
Able to assist patient/family with questions or concerns about their account as it pertains to payment/reimbursement and setting up payment contracts
Performs insurance billing clerical duties including review and verification of patient account information against payer program specifications
May enter data electronically to process charges, payments. denials and adjustments
Understands the Revenue Cycle
Maintains knowledge of Federal, State and local billing regulations, and informs management and compliance department of discrepancies
Completes and submits claims for payment, electronic or hard copy, including initial billing, all insurance re-billing, and secondary or subsequent billings
Responsible for accuracy and third party compliance in all aspects of billing activities in particular in relating to clinical attachments, cpt coding, occurrence, condition and value codes, pre-certification, contractual adjustments or required forms
Strictly adheres to all rules/regulations and quickly responds to changes, as notified by insurance carriers, employers, third party payers, or government agencies
Understands the relationship of timely and thorough claims follow-up to assist in the reduction of days in accounts receivable and payer turn around
Has a thorough understanding of all HMO, PPO, or managed care contractual relationships and able to determine if correct payments and adjustments were made
Able to identify a credit balance account and make the correct determination as to who/where the credit balance should be refunded or transferred
Reports all repeated errors or omissions of patient insurance and demographic information to the manager
Corrects all claims edits or errors promptly and before submission
Prioritizes issues and workload effectively
Works effectively as both a team member and individual


Other information:
High School Diploma or equivalent
Associates Degree preferred
Must have some post HS education, preferably in accounting, information systems or third party billings

Demonstrates excellent customer service skills
Minimal typing skills of 35 words/ minute
Must possess clerical skills:10-key, computer, telephone, copier
Must have good written and oral communication skills

Must have a minimum of 18-24 months of relevant work experience or equivalent combination of training and relevant work experience
Hospital billing and insurance claim processing experience preferred
Insurance and/or account follow-up techniques experience preferred
Ability to communicate effectively both verbally and in writing
Should have strong working knowledge of departmental policies, procedures and business operations and how they interrelate to other departments in the organization
Knowledge of third party billing and collections
Basic understanding of UB-92, 1500,CPT, ICD-9 Coding
Knowledge of hospital and/or medical billing and insurance claim filing
Knowledge of insurance and/or account follow-up
Knowledge of medical and insurance terminology
Strong working knowledge of Excel, Word, and PowerPoint preferred
Must be a team player with the ability to work independently as well as in small or large teams
Protects and maintains the confidential nature of information





It has been determined that Covenant HealthCare cannot provide a latex safe or latex free work environment at any of its facilities.  Unfortunately, that means that any individual, including an applicant or an employee, is likely to be exposed to latex while on Covenant's premises.  Therefore, latex tolerance is considered to be an essential function for any position with Covenant.

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