Lead CAH Billing and Denial Specialist (Full Time)

Benefis is one of Montana’s largest and premier health systems, and we are committed to providing excellent care for all, healing body, mind, and spirit. At Benefis, we work hard to support our employees in every aspect of their careers by offering outstanding benefits and compensation, state-of-the-art facilities, and multiple growth opportunities. The only thing missing is you!

Responsible for accurate and timely submission of claims and resolution of assigned accounts receivable. Contacts payers or accesses electronic media regarding claim payment and resolution. Answers insurance representative or patient account questions for resolution of claims. Performs functions relative to denial management, provides feedback to departments and reporting to Management. Compiles and reports monthly denials and avoidable write offs to Supervisor and Manager after reviewing for trends.

Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations. Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict.

Will perform all job duties or job tasks as assigned. Will follow and adhere to all requirements, regulations and procedures of any licensing board or agency. Must comply with all Benefis Health System’s organization policies and procedures.

Education/License/Experience Requirements:

• Three (3) years prior Patient Business Services experience or equivalent of 3 years previous experience in a healthcare field
• Knowledge of Critical Access Hospital, Method I and II Billing
• Knowledge of Rural Health Clinic Billing preferable
• Knowledge of CPT/HCPCS along with ICD-9, ICD-10 coding terminology
• Knowledge of Medicare and Medicaid billing requirements as well as all Commercial payers
• Knowledge of Medicare and Medicaid NCCI, LCD, NCD and MUE edits and all updates