CHI Health Clinic

Claims Processor

  • CHI Health Clinic
  • Remote
  • About 1 month ago

Job Description

Overview


Remote Opportunity

This position can be fully remote or work out of the office in Lincoln, Omaha or LIttle Falls Office.

(40 hour work week - the hours can be a start time anytime 6 am to 8 am)


Your time at work should be fulfilling.
Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities.


CHI Health provides you with the same level of care you provide for others. We care about our employees’ well-being and offer benefits that complement work/life balance.


With you in mind, we offer the following benefits to support your work/life balance:

  • Health/Dental/Vision Insurance
  • Direct Primary Plan (No copay, no deductible, and access to CHI Health provider 24/7)
  • Premium Access to our Family Care Program supporting your needs for childcare, pet care, and/or adult dependent care
  • Voluntary Protection: Group Accident, Critical Illness, and Identity Theft
  • Employee Assistance Program (EAP) for you and your family
  • Paid Time Off (PTO)
  • Tuition Assistance for career growth and development
  • Matching 401(k) and 457(b) Retirement Programs
  • Adoption Assistance
  • Wellness Programs
  • Flexible spending accounts

From primary to specialty care as well as walk-in and virtual services CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.

Responsibilities


This job is responsible for submitting claims in accordance with payer regulations and applicable guidelines. An incumbent will facilitate the overall claim process through submission of both electronic and paper-based claims, resolution of claim-form edits and validation of data integrity.

Work requires an understanding of detailed billing requirements, claims attachments and claim rejections, as well as attention to detail, the ability to accurately and timely troubleshoot/resolve questions/issues and to resolve (within scope of the position) issues which may have a potential impact on revenues.

  • Transmits/retrieves electronic patient claims/files to and from the claims clearinghouse in accordance with established procedures.
  • Reviews claims for all necessary requirements for billing, including complete patient and insurance information; completes paper claim processing in a timely and accurate manner.
  • Resolves all claim edits, in both the billing system and the clearinghouse, accurately and timely through attention to detail and critical thinking skills in accordance with payer regulations and guidelines.
  • Identifies and researches unusual, complex or escalated issues as assigned; applies problem-solving and critical thinking skills as necessary to resolve issues within the scope of position authority.
  • Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records.
  • Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function.
  • Other duties as assigned by management.

Qualifications

What you will need:

Graduation from a post-high school program in medical billing or other business-related field is preferred


High School Diploma or GED Preferred

Pay Range

$17.89 - $24.60 /hour

Jobs of Interest