Billing Specialist

Community Action Partnerships of Western Nebraska (CAPWN) is a non‑profit community‑based health and human services organization that serves low‑income, disadvantaged and those unable to meet their needs through other sources. The agency was established in 1965 and provides services to over 9,000 individuals, children and families in three main areas:

• Community Health Services
  : WIC, Commodity Supplemental Food, Foster Grandparents, Head Start, and Child Development Center.
• Clinical Health Services
  :
  Primary Care, Reproductive Health, Diabetes Management, Immunizations, Migrant Health, Ryan White HIV;
  Behavioral Health including Counseling Services, Medication Management, Medication Assisted Treatment and Substance Use Counseling and Intensive Outpatient Services and Dental Services.
• Supportive Health Services
  :
  Family Stabilization, a Teen Outreach Program, SOAR, Youth Leadership Program, Youth Shelter and Housing Assistance Programs.

OUR PROMISE
:
Community Action changes people’s lives, embodies the spirit of hope, improves communities, and makes America a better place to live. We care about the entire community, and we are dedicated to helping people help themselves and each other.

VISION

Communities where everyone has an opportunity for a successful life.

MISSION

The Mission Statement of the Community Action Partnership of Western Nebraska is to provide quality services and promote learning opportunities to improve nurture the health and well‑being of Western Nebraska communities.

KEY BELIEFS

• Integrity— We treat all people with dignity and respect.
• Compassion— We believe working compassionately with people enriches all.
• Inclusion— We are inclusive and advocate for diversity.
• Collaboration— We believe working in partnerships strengthens communities; we seek mutually beneficial partnerships that advance a common mission.
• Innovation— We embrace opportunities to learn, grow and make wise choices.

COMPETITIVE BENEFITS PACKAGE
:

Fulltime (40 hours)

7:00 AM - 4:00 PM

Monday through Friday

***
* REQUIRED:

ONSITE Position*****

Reports To
:
Billing Manager

Areas of Responsibility
:
Responsible for all aspects of the Health Center’s billing including charge entry, general coding guidelines, payment posting, account receivables management, rejection, and denial management.

Major Duties
:

• Work with patients to answer billing questions and concerns; facilitate error correction when needed or elevate to the appropriate internal party.
• Maintain and update spreadsheets and tracking pertaining to account balances, aging, and claim rejections/denials accurately and timely.
• Complete daily account billing: generate claims, mail claims or send electronically to appropriate insurance carrier. Routinely analyze and work claims that are rejected or denied.
• Assure adjustments and payments are made appropriately and accurately in the Electronic Practice Management system.
• Remain current with agency billing policies and ensure billing processes are following agency billing policies.
• Assure timely identification of patient account credit balances and processing of refunds.
• Manage accounts receivable by performing collection activity procedure to past due A/R accounts of insurance carriers and clients.
• Make recommendations to the Billing Manager for problem resolution and identification of erroneous processes at the front end of the billing cycle and encounters.
• Accurately document all activity taken in each patient’s account.
• Maintain understanding of 3 rd party billing hierarchy.
• Maintain understanding of current coding and billing regulations and compliance requirements for the Bureau of Primary Health Care, Medicaid, Medicare, and private billing/insurance companies.
• Remain current with ICD-10, CPT and HCPSS codes and users.
• Participate in educational activities and attend regular team and agency meetings.
• Maintain confidentiality of records and communications following HIPAA privacy and security policies and procedures.
• As a CAPWN team member, dedicate your energy to providing high quality, value‑added customer service and care to our clients. Embrace the CAPWN Standard of Behavior, practicing integrity, strong communication and respect for leaders and…