Medical Billing Specialist (Hybrid)

Initial Posting Date: 09/19/2024 Application Deadline: 09/29/2024 Agency: Oregon Health Authority Salary Range: $3,948 - $5,483 Position Type: Employee Position Title: Medical Billing Specialist (Hybrid) Job Description: This is a 12 month limited duration position: Hybrid Work: 80% of the work is remote What you will do! The primary responsibility of this role is to determine Medicare and insurance eligibility for all patients admitted to the Oregon State Hospital locations in Salem and Junction City. The specialist will facilitate and oversee medical billing processes, resolve issues related to Medicare, Medicaid, and third-party payments, and ensure compliance with insurance billing regulations through audits of medical records. Additionally, this role involves researching and assisting with the review of federal rules to stay current on changes impacting claims submission, processing, and coverage. Key duties include generating insurance claims for eligible services, managing claims through various payment cycles, and addressing denied or rejected claims. This position will collaborate closely with the Utilization Management department, Medical Coding, and Health Information teams. What's in it for you? We offer a workplace that balances productivity with enjoyment; promotes an atmosphere of mutual respect, dedication, and enthusiasm. You will collaborate in an open office with a team of bright individuals to work with and learn from. We offer full medical, vision, and dental , we pay 95% to 99% of medical insurance premiums for full-time employees, including mental health coverage. We also offer 8 hours of paid sick leave per month, 8 hours of paid vacation leave per month, 24 hours of personal leave each year, and eleven paid holidays per year plus pension and retirement plans . If you're driven by the passion to do something meaningful that changes lives, the Oregon Health Authority is the place for you. If you have federal student loan debt or are thinking of going back to school, then you might benefit from the Student Loan Forgiveness Program . If you make 120 qualifying payments on your student loan while working full-time for a qualifying employer, your student loan debt may be forgiven. This recruitment will be used to fill one permanent, full-time positions located in Salem, OR (29398 Recovery Way) and may be used to fill future vacancies as they occur. This position is represented by Service Employees International Union (SEIU). OHA values health equity, service excellence, integrity, leadership, partnership, innovation and transparency. OHA’s health equity definition is “Oregon will have established a health system that creates health equity when all people can reach their full potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, age, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances. Achieving health equity requires the ongoing collaboration of all regions and sectors of the state, including tribal governments to address: the equitable distribution or redistributing of resources and power; and recognizing, reconciling, and rectifying historical and contemporary injustices.” OHA’s 10-year goal is to eliminate health inequities. Click here , to learn more about OHA’s mission, vision and core values. Duties Identify Patient Eligibility: Determine Medicare and insurance eligibility for patients admitted to the Oregon State Hospital (Salem and Junction City locations). Medical Billing: Facilitate and complete medical billing processes for hospital patients. Generate insurance claims for eligible services and submit them to the appropriate payors. Claims Management: Monitor and manage claims through various payor cycles. Investigate and resolve denied or rejected claims, ensuring timely and accurate payment. Compliance Auditing: Audit medical records for compliance with Medicare, Medicaid, and third-party billing regulations. Ensure all billing activities align with current regulations and hospital policies. Problem Resolution: Address Medicare, Medicaid, and third-party billing/payment issues. Act as a resource for resolving complex billing discrepancies. Research and Policy Monitoring: Stay updated on federal rules and regulations affecting claims submission and covered services. Assist in researching policy changes and their impact on billing procedures. Collaboration: Work closely with the Utilization Management department to ensure accurate claims submission. Partner with Medical Coding and Health Information teams to ensure correct documentation and billing practices. Minimum Qualifications: Three years of secretarial or administrative support experience that includes coordinating office procedures, preparing narrative and statistical reports, and administrative data collection and analysis; OR An associate degree in general office occupations and two years of secretarial or administrative support experience that includes coordinating office procedures, preparing narrative and statistical reports, and administrative data collection and analysis; OR An equivalent combination of education and experience. Special Qualifications: Must demonstrate strong interpersonal skills, including tact and patience, to work effectively with both patients and hospital staff without disrupting treatment priorities. Experience and/or training in third-party payer billing, with a focus on Medicare Parts A and B, and a thorough understanding of billing practices and processes. Proficiency in mathematics and strong computer skills, including accurate typing ability. Ability to interpret and implement regulatory standards, and follow operational guidelines effectively. Strong written and verbal communication skills, with the ability to convey information clearly in person and in writing. Experience, training, and/or certification in coding procedures and diagnoses, following CPT and ICD-9/ICD-10 guidelines. How to apply: Complete the online application. Complete the Questionnaire Complete Cover Letter (Required) Attach a Resume (Required) Please ensure you’ve provided a thorough and updated application as it pertains to the position for which you are applying. Your application materials will be used to determine salary based on a pay equity assessment. For further information, please visit the Pay Equity Project homepage. Questions/Need Help? If you need assistance to participate in the application process, including an accommodation request under the Americans with Disabilities Act contact at Barry Lein 503-440-6484 Barry.lein@oha.oregon.go Additional Information Please monitor your Workday account, as all communication will be sent to your Workday account. You must have a valid e-mail address to apply. If you are a veteran, you may receive preference. Click here for more information about veterans’ preference. If you checked that you are a veteran, we will ask you for your documents later in the process. We do not offer VISA sponsorships or transfers at this time – unless specifically noted. Within three days of hire, you will be required to complete the US Department of Homeland Security's I-9 form confirming authorization to work in the United States If you are offered employment, the offer will be contingent upon the outcome of an abuse check, criminal records check and driving records check, and the information shall be shared with the Oregon Health Authority (OHA), Office of Human Resources (OHR). Any criminal or founded abuse history will be reviewed and could result in the withdrawal of the offer or termination of employment. Candidates who are offered employment at the Oregon State Hospital must satisfactorily pass a pre-employment drug test. Please only attach documents that are related to the position. Additional documents that are attached will not be reviewed. Employees at the Oregon State Hospital may be exposed to the handling, administration, waste, and spill cleanup of hazardous medications, which may result in health impacts to the employee. Applicants can review the Oregon State Hospital's anti-retaliation notice at www.oregon.gov/oha/OSH/Documents/SB469.pdf Applicant Help and Support webpage. The Oregon Health Authority is committed to fair employment practices and non-discrimination, including pay equity for all employees. We do not discriminate on the basis of protected class (race, sex, veteran status, disability, age, color, religion, national origin, marital status, sexual orientation) in the payment of wages or screen applicants on the basis of their current or past compensation. We determine salary by completing a review of your application materials to evaluate your related education, experience, and training for this position. (critical elements of the process). The Oregon Health Authority is an equal opportunity, affirmative action employer committed to work force diversity and anti-racism.