Day in the Life of a Billing Specialist:

This position is responsible for the timeliness and accuracy of patient account billing and payer reimbursement by ensuring that coordination of benefits is accurate, and that payer reimbursement is appropriate as agreed upon in our organizational payer contracts. The Billing Representative provides outstanding customer service to our customers who include but may not be limited to; Patients, Guarantors, Providers, Health Insurance Companies, Third Party Liability Companies and Cheyenne Regional staff.

Why work at Cheyenne Regional?

• 403(b) with 4% employer match
• ANCC Magnet Hospital
• 21 PTO days per year (increases with tenure)
• Education Assistance Program
• Employee Sponsored Wellness Program
• Employee Assistance Program
• Loan Forgiveness Eligible

Here is what you will be doing:

• Pursues and participates in education for assigned payer to remain current with changes in the healthcare industry via payer websites, payer newsletters, webinar and attendance at assigned payer meetings.
• Reviews accounts each day in assigned Epic Work Queues and prioritize by dollar amount and timely filing rules to achieve the best possible reimbursement.
• Completes necessary research to submit claims to appropriate payer based on coordination of benefits and active coverage at time service was rendered.
• Evaluates payer remittance advice and/or explanation of benefits on denials for accuracy according to individual payer contracts.
• Maintains knowledge of Medicare, Medicaid, and all commercial insurance programs, including Medicare HMO’s and State Programs to include filing deadlines, billing requirements, and reimbursement methods.
• Composes and submits appeals to third party payers, appealing to the highest level to resolve account denial for proper reimbursement.
• Receives and researches patient, payer, attorney, and third party inquiries received through incoming calls and correspondence in a timely manner by reviewing all available information including payer remits, contracts, documentation, policies and procedures, and insurance laws to formulate an informative response and direct the account appropriately.
• Maintains or exceeds performance metrics according to job assignment focusing on reduction to Accounts Receivable Days and Denial Rates.
• Provides feedback to management on denial trends and claim edits to assist with process improvement and quality assurance within our billing software.
• Provides exemplary customer service and demonstrate positive communication skills in a courteous, accurate and honest manner.

HOME CARE: Performs intake responsibilities and obtains patient insurance benefits information ensuring pre-certifications, authorization and referral requirements are met prior to the delivery of home care services. Maintains current authorizations and manages work queues. Performs other duties as assigned by Lead Billing Specialist.

Desired skills:

• Knowledge and understanding of Federal and State billing and coding regulations and compliance
• Knowledge and understanding of HIPAA
• Ability to multitask with a high attention to detail
• Must have the ability to type a minimum of 40 wpm
• Ability to handle cash
• Knowledge of medical terminology and coding

Here is what you will need:

• High school diploma (or Equivalent Certificate from an accredited program) or higher degree

Nice to have:

• Completion of Billing/Coding Program with Certification
• Prior customer service or finance experience

About Cheyenne Regional:

Cheyenne Regional Medical Center was founded in 1867 as a tent hospital by the Union Pacific Railroad to treat workers injured while building the transcontinental railroad. Today, we are the largest hospital in the state of Wyoming, employing over 2,000 people, and treating over 350,000 patients from southeastern Wyoming, western Nebraska, and northern Colorado. We pride ourselves on patient and employee experience by living our core values of Integrity, Caring, Compassion, Respect, Service, Teamwork and Excellence to I.N.S.P.I.R.E. great health.

Our team makes a difference every day by providing trusted healthcare expertise through a passionate and I.N.S.P.I.R.E.(ing) approach with a personal touch. By living our values, we aim to achieve our goal of becoming a 5-star rated hospital, providing critical support and resources to our community and the greater region we serve. If you are eager to make a difference and passionate about healthcare, we encourage you to apply today!