Revenue Cycle Insurance Biller

As our Revenue Cycle Insurance Biller, you will play a pivotal role in maintaining the financial health of our healthcare organization. You will be responsible for the end-to-end management of electronic and paper claims, ensuring that all submissions are accurate, compliant, and processed efficiently. By leveraging your expertise in medical coding and payer requirements, you will bridge the gap between clinical services and revenue realization, directly impacting our operational success and patient satisfaction.

Every day you will manage the full revenue cycle workflow, starting with the scrubbing of claims to ensure they are clean and error-free before submission to insurance carriers. You will proactively resolve billing edits, address claim rejections, and validate insurance eligibility to minimize denials. Your daily routine will also involve managing secondary insurance billing, posting necessary adjustments, and collaborating with cross-functional teams to resolve complex billing discrepancies that require meticulous attention to detail.

To be successful in this role, you will possess a strong command of ICD-10 and CPT coding standards, combined with a commitment to staying current on evolving insurance billing guidelines. You are a detail-oriented professional who excels at identifying trends in claims processing and participating in process improvement initiatives to drive departmental efficiency. With your professional communication skills and ability to meet strict productivity and quality assurance benchmarks, you will ensure our billing operations remain seamless, compliant, and highly effective.

• Process and export clean claims to payers within 24 hours of import.
• Resolve billing software edits within 7 days to accelerate reimbursement cycles.
• Manage claim rejections by correcting coding errors and verifying patient insurance eligibility.
• Maintain high-level proficiency in medical coding and current billing compliance regulations.
• Collaborate with clinic leadership to identify and resolve recurring billing patterns.
• Meet or exceed established Fiscal Year goals for QA accuracy and daily productivity.

Required

• High School Graduate 
• Two years Hospital billing/collection experience or other related healthcare provider claims experience in a high volume medical healthcare claim environment. (Includes health plan, hospital claims, reimbursement, appeals experience) 
• AHCCCS/ Medicare/government Commercial payer 
• UB-04 billing 
• Previous experience with computerized billing systems, WordProcessing and Spreadsheet applications 

Preferred

• Four years Hospital billing/collection experience
• College level business courses
• Two years relevant college education and experience
• Experience with Google Workplace applications, Billing clearing house and Cerner

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.