Medical Collections/Billing Specialist

DEPARTMENT: Business Office REPORTS TO: Business Office Manager SALARY: D.
O.
E.
JOB STATUS: Full-time, Permanent, Non-Exempt OPEN DATE: 10/26/2023 CLOSE DATE: Until Filled JOB SUMMARY: The incumbent will review and make necessary changes to daily Medical Claims in RPMS when needed.
Otherwise, the incumbent will work 3rd Party rejected and denied claims daily until claims are paid in full.
DUTIES AND RESPONSIBILITIES: Batch and review claims when needed for Arapahoe, Riverton and Ethete clinics, otherwise will work 3rd Party rejected and denied claims for all 3 clinics daily.
Check all Professional and Institutional claim rejections on a daily basis in the clearinghouse and make corrections if needed then upload to the 3rd Party payer.
Maintains standards to ensure systematic, consistent, and timely collection follow-up.
Makes follow-up calls to various 3rd Party Payers with outstanding balances over 30 days.
Open to being cross trained to other functions within the business office and provide support in these areas as needed.
Manages time well, being on time, thinking of better ways to do things.
Other duties as assigned to maintain and enhance the operation of the department.
QUALIFICATIONS: High School Diploma or equivalent.
Associate degree (Preferred) Medical Billing: 1 year (Preferred) Medical office: 1 year (Preferred) RPMS (Electronic Health Record) experience (Preferred) Competent in computer programs, such as MS Word, Excel and Google applications i.
e.
Google sheets, Gmail as well as use standard office equipment.
Knowledge of medical terminology, and HIPAA standards.
Skilled in organization required.
Skilled in attention to detail required.
ENVIRONMENTAL AND WORKING CONDITIONS May be exposed to noise in the office.
Prolonged or considerable sitting and/or standing.
Lifting boxes or medical records totaling up to 35 lbs.
Able to move about inside office to access file cabinets, office machinery.
Climbing Stairs EMPLOYEE BENEFITS: Competitive wages (no state or local tax) 18 different medical insurance packages Dental and vision insurance Life insurance Retirement plan with 4% match Leave Benefits IMPORTANT APPLICATION CRITERIA: Submit a complete application with supporting documents either online or to WRFCHC Human Resource Department located at 120 North 6th East St (Old DFS Bldg.
), Riverton WY.
Applicants must submit all supporting documents to be eligible for the position they are applying for.
Supporting documents: Driver’s License, Tribal ID, High School Diploma/GED, Degree or professional credentials, and other supporting documents that verify required qualifications.
Applicants not living in the local area may submit a cover letter, resume, and supporting documents in lieu of an application as an initial statement of interest for a particular job announcement.
However, the applicant must follow-up with an official Wind River Family and Community Health Care job application.
Applicants who have a current application on file are required to submit a letter of interest for each position in which they want to be considered for.
The letter should address how they meet each qualification.
Supporting documents must be attached to the letter of interest.
Telephone calls are not accepted in place of an employment application or letter of interest.
When the position qualifications require a driver’s license, education, or professional credentials, the applicant must submit copies of certificates, licenses, degrees, and other supporting documentation.
Applicants who do not provide supporting documents will be disqualified.
WRFCHC is an Equal Opportunity Employer.
Preference will be given to a qualified tribal member, then a qualified tribal member of a federally recognized tribe and then other qualified candidates.
Qualified Indian Preference applicants must provide a copy of their tribal enrollment identification card or a Certificate of Indian Blood.
Background investigation, drug and alcohol screening are required as a condition of employment.
Refusal will render the applicant ineligible for employment.
For information or questions, please contact Human Resources at 307-856-9281 ext.
367.