Claims Processor position open at Pacific University (Billing only, no coding)

PPietras

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Job #: 1422

As the Claims Processor for the Central Billing Office for Pacific University Healthcare Clinics utilizing OCHIN Epic this position is the primary contact for the clinics in billing matters and is responsible for monitoring billing work queues for all clinics, maintaining billing workflows, monitoring Accounts Receivable for each clinic, and providing month-end reports to the Business Office for each clinic. Claims Processor will be the primary liaison between the Central Billing Office and OCHIN.

ESSENTIAL FUNCTIONS / MAJOR RESPONSIBILITIES:

· Works closely with the EHR Specialist/Billing Manager and each clinics administrative staff to clearly understand the billing processes for the clinics.

· Develop and maintain strong collaborative working relationships with clinic staff and demonstrates effective communication with others.

· Responsible for maintaining up-to-date documentation of Central Billing office workflows for each clinic.

· Responsible for monitoring and maintaining the Billing Work queues for each clinic within Epic in a timely manner.

· Responsible for all Invoice billing for PCH Clinics, maintaining documentation and data entry into Epic on a monthly basis.

· Oversees timely review and acceptance of claim and patient statement runs through Epic and Trizetto EDI.

· Responsible for the posting of insurance and patient payments, standard courtesy and social service adjustments. Applies third party billing expertise to properly determine coverage and for clean claims submission. Works to maintain the accounts receivable balance at an acceptable level for each clinic.

· Monitors multiple insurance company portals in tracking electronic payments made to different clinics.

· Effectively communicates financial obligations to patients and communicates with patients if their account is delinquent based on clinic policy.

· Provides month-end and year-end financial reports for all clinics and the Business Office in a timely manner.

· Provides report writing support for clinics requesting financial reports produced in Crystal Reports using the Clarity database and/or using Epic’s Reporting Workbench.

SECONDARY RESPONSIBILITES:

· Willingly performs other position-related or implied tasks and continuously explores ways to optimize Epic utilization.

· Perform other related duties as assigned.

JOB SCOPE: Performs duties independently with minimal supervision, operating from specific and definite directions and instructions, yet work is checked or verified on a frequent basis. Decisions are made within general university policy constraints but occasionally require independent decision making. Errors could affect the smooth and efficient operation of the office.

EDUCATION AND/OR EXPERIENCE:

· Previous experience working in a health care facility in medical insurance billing is A MUST. Applicants without medical insurance billing experience will not be considered.

· Billing certification from a professional organization preferred (i.e. AAPC, MAB, etc.).

· Epic EHR experience a plus.

· Crystal Reports report writing experience preferred.

REQUIRED KNOWLEDGE, SKILLS, ABILITIES & BEHAVIORS:

· MUST have a minimum of 1 year of previous medical insurance billing experience.

· Communicates professionally with students, faculty, staff and the public appropriate to the age of the individual served.

· Must possess the skills and motivation necessary to work independently and as a team member.

· Must be highly organized, flexible, sensitive to meeting deadlines, and able to exercise good judgment in prioritizing and developing efficient work methods.

· Builds on basic learning and carries it from one situation to another.

· Demonstrates critical thinking skills in problem solving and decision-making.

· Asks questions and seeks assistance.

· Takes responsibility to eliminate the source of problems by communicating with the Billing Manager.

· Demonstrates confidentiality regarding information pertaining to all students, faculty and staff, and patients.

· Maintains proper appearance and personal conduct for the employee’s particular job.

· Uses effective communication skills taking into consideration body language, filters, listening, paraphrasing, and questions with customers of diverse ethnic and cultural backgrounds.

· Excellent verbal and written communication skills and the ability to apply good judgment and a professional manner when interacting with patients, students, and others in the health care community.

· Strong word processing and database management skills. Working knowledge of computers and standard office equipment.

· Ability to maintain accuracy in numerous detailed record-keeping tasks.

· Bi-lingual – English and Spanish – helpful, but not required.

WORKING CONDITIONS: Clinic office environment.

PHYSICAL ACTIVITIES: Stooping, Kneeling, Reaching, Standing, Walking, Pushing, Pulling, Lifting, Fingering, Grasping, Talking, Hearing, Repetitive motion

PHYSICAL REQUIREMENTS: Light work, Visual acuity

APPLICATION: Please email cover letter, resume and names and phone numbers of three professional references to employment@pacificu.edu. Please name your documents as shown in the following example: (Example: Adams_Amy letter, Adams_Amy resume, Adams_Amy references). You may also mail your application materials to Human Resources/Pacific University, 2043 College Way, Forest Grove, OR 97116.

Application materials will be screened and interview candidates will be selected and notified. The hiring process normally consists of several interviews and can last several weeks depending on the position. Employment is contingent upon eligibility to work in the United States and successful completion of a background check. If the position is posted on our job board at http://www.pacificu.edu/hr/employment/positions/index.cfm it is an available position and you may apply. No phone calls please.

DISCOVER PACIFIC UNIVERSITY

Pacific University is a small but diverse community, where students thrive in a personal academic environment. Tracing its roots back to 1849, when it began as a school for orphans of the Oregon Trail, Pacific has long been devoted to making a difference in people’s lives. Nestled in the valley at the base of the coastal range and Mount Hood, the university is only a half hour to the Portland metro center.

Today, students study in a unique combination of undergraduate, graduate and professional programs in the liberal arts and sciences, optometry, education, health professions and business. Pacific University has campuses in Forest Grove, Hillsboro, Eugene and Woodburn, Ore., as well as an office in Honolulu. In addition, a variety of Pacific University health and eye clinics throughout the Portland area serve patients and provide students with practical experience.

At Pacific University, students and faculty engage in discovery through close, nurturing relationships that provide extraordinary learning experiences. International study, service learning, internships and co-curricular activities have been integral parts of the education of nearly 25,000 alumni worldwide who share in the Boxer spirit.

NOTICE OF NONDISCRIMINATION POLICY

It is the policy of Pacific University not to discriminate on the basis of sex, physical or mental disability, race, color, national origin, sexual orientation, age, religious preference or disabled veteran or Vietnam Era status in admission and access to, or treatment in employment, educational programs or activities as required by Title IX of the Education Amendments of 1972, section 504 of the Rehabilitation Act of 1973, Title VII of the Civil Rights Act of 1964, the Age Discrimination Act, the Americans with Disabilities Act of 1990, or any other classification protected under state or federal law, or city ordinance. Questions or complaints may be directed to the Vice President for Academic Affairs, 2043 College Way, Forest Grove, OR 97116, provost@pacificu.edu.
 
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