Billing Processor

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsible for compiling and maintaining records of charges for goods and services rendered and ensuring accurate and
efficient charge entry at MedQuest. Is held accountable for policies and procedures of the department and organization.
This position supports the mission, vision, and philosophy of CommonSpirit Health.

Responsible for all billing functions;
2. Works directly with customers, referral sources, and other providers in assuring proper billing practices are
adhered to;
3. Submits, tracks, and enters Certificate of Medical Necessities, prescriptions, and prior authorizations as
needed;
4. Responsible for chart review for Quality Improvement;
5. Accurately reviews the claims pending list for paperwork return;
6. Responsible for the education/training of staff regarding billing coverage;
7. Responsible for electronic claims submission and posting of payments
8. Provides customer service assistance;
9. Other duties as assigned.

Identifies and researches unusual, complex or escalated issues as assigned; applies problem-solving and critical thinking skills as necessary to resolve issues within the scope of position authority. 

• Notifies Supervisor/Manager of other ongoing issues and concerns.

Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. 

• Meets quality assurance and productivity standards for timely and accurate claim submission in accordance with organizational policies and procedures. 

Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function.

• Applies current knowledge of detailed billing requirements, claim attachments and rejections.
• Has knowledge of, and is compliant with, government regulations including "signature on file" requirements,   compliance program, HIPAA, etc.

Required Education and Licensure

• High School Diploma or GED 

Required Minimum Experience

• Four years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities.

Bona Fide Occupational Qualifications (BFOQs)

• N/A

Preferred Qualifications

• Graduation from a post-high school program in medical billing or other business-related field is preferred