Billing Clerk @ ibnjjb.fa.ocs.oraclecloud.com

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

Your experience matters

Memorial Medical Center is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Billing Clerk, joining our team, you’re embracing a vital mission dedicated to making communities healthier ®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

How you'll contribute

A Billing Clerk who excels in this role:

• Manages the billing process through the preparation and transmittal of accurate and complete bills in a timely manner to Medicare, Medicaid and other third-party payers.
• Follows established policies and procedures. objectives, safety standards, and sensitivity to confidential information.
• Processes 100% of accepted claims within one working day of receipt.
• Edits claims to completion, exhausting all resources to meet established guidelines.
• Enters 100% documentation immediately upon receipt, keeping account information current and accurate.
• Updates billing system with demographic and/or insurance revisions within one working day of receipt.
• Submits daily to manager those claims requiring additional information from Admitting/Registration staff.
• Initiates follow up to third party payers no later than 15 days from final bill.
• Works accounts to completion to ensure adjudication within 90 days from bill.
• Actively follows up on all rejected and unpaid claims.
• Obtains and/or supply payers with necessary information and/or documentation to expedite payment in accordance with payer guidelines.
• Maintains current knowledge of CPT-HCPCS and ICD- 10 coding in accordance with third party payer guidelines for UB94 and HCFA 1500 claims.
• Reviews accounts for accuracy of patient balances and insurance portions due, to ensure correct statements are mailed.
• Maintains knowledge of payer contracts and reimbursement methodologist to insure correct payment and patient portion due.
• Reviews and follow up on any charges credited or debited on patient accounts in accordance with established guidelines.
• Follows up on denied, rejected and/or pending claims via remittance advice, Medicare FSS and other electronic systems within two working days or receipt.
• Maintains reliable comprehensive cash controls to ensure timely and accurate ash applications to patient accounts.
• Applies payments, calculate, process and generate adjustments not completed by the electronic remittance process within one working day or receipt.
• Prepares daily reconciliation of cash and adjustment posting and forward a copy to the accounting department.
• Reviews and research credit balances and resolve within five (5) working days.
• Resolves all incoming no payment correspondence within five (5) working days.
• Remains knowledgeable in the operation of the electronic remittance system to facilitate use when needed.
• Makes referrals of accounts to appropriate department, with a high level of accuracy, for payment offsets and appeals.
• Keeps manager appropriately informed of problems/issues or needs of the department.
• Guards the confidentiality of patient record and report any breach of confidentiality to the manager.
• Assists auditors with requested information for review of accounts and process corrected claims as necessary.
• Notifies department manager of absence or tardy, giving sufficient notice to provide coverage for the work area.
• Specific duties (may vary daily) to be performed will be assigned by the manager depending upon the needs and requirements of the department and hospital to ensure all individuals are crossed trained in each area of responsibility.
• Interacts with Patient Account Manager and/or Benefits Advisor related to patients with limited or no insurance coverage, personal portion payment and deductibles owed; and follows up with patient regarding insurance problems via phone or mail.
• Demonstrates professional, courteous, caring telephone etiquette.
• Retains business office records in readily retrievable fashion.
• Maintains clean claims submission to 80% or better.
• Maintains confidentiality in accordance with HIPAA regulations.
• Performs other related duties as assigned or requested.

What we’re looking for

Education

• High School diploma or equivalent is required.
• Two years of college coursework completed or equivalent work experience is preferred.

Skills

• Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
• Must be able to work in a stressful environment and take appropriate action.

Experience

• Preferred: Previous insurance billing experience or analytical experience determining priorities, where options are limited.

Schedule: Full-time

Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Professional Development: Ongoing learning and career advancement opportunities.

More about Memorial Medical Center

Memorial Medical Center is a 199-bed acute medical/surgical teaching hospital located in Las Cruces, NM, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier® with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone—your experience matters.

EEOC Statement

Memorial Medical Center is an Equal Opportunity Employer. Memorial Medical Center is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.