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, Migrant Seasonal 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 :

Health Dental Vision Health Savings Account (HSA) Flex Plan 401k Basic and Voluntary Life Insurance Ten Paid Holidays PTO Extended Illness (EIB) Employee Assistance Program Aflac Community Discounts Potential for Incentive Pay

Billing Specialist

Full-Time Monday-Friday 7AM to 4PM

Areas of Responsibility : Responsible for all aspects of the Community Action Health Center (CAHC) billing to include 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 escalate to the appropriate internal party.
• Develop and implement audits to review billing and collection patterns and make corrective recommendations.
• Develop routine ongoing reports for the Billing Manager pertaining to account balances, aging, claim rejections / denials and help to identify trends or issues
• Routinely analyze and work claims that are rejected or denied.
• Assist Billing Manager with coding, charge entry and claims submission.
• Assure adjustments 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.
• Make recommendations to the Billing Manager for problem resolution and identification of erroneous processes on the front end of the billing cycle and encounters.
• Accurately document all activity taken in each patient’s account.
• Maintaining understanding of 3

party billing hierarchy and correct Electronic Practice Management system set up as needed.

• 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 patient confidentiality for Protected Health Information (PHI) or Electronic Protected Health Information (ePHI) according to HIPAA law and CAPWN policy.
• As a CAPWN team member, dedicate your energy to providing high quality, value-added customer service and care to our clients.

Embrace the CAPWN Code of Conduct, practicing integrity, strong communication and respect for leaders and peers. Engage with the team and commit to improving and nurturing the health and well-being of the Western Nebraska Communities we serve.

All other duties as assigned.

Working Conditions :

• General office environment : work is generally sedentary in nature but may require standing and walking for up to 10% of the time.
• May encounter stressful environment where timelines are critical.

Physical Requirements :

• Must be able to read, write, and communicate fluently in English.
• Must be physically and emotionally able to work with clients, vendors, and other employees.
• Must regularly talk, hear, and have close vision ability.
• Ability to bend, stoop, squat, crouch, push and pull file drawers.
• Fine manipulation of the hands with repetitive action including typing.
• Operate office machines, printers, computers, adding machines.
• Occasional lifting and carrying up to 25 pounds.

Minimum Qualifications :

Grade : 13

• High School diploma or GED required.
• Three years’ experience with health-related billing processes preferred.
• Ability to develop and utilize an understanding of medical terminology.
• Have computer skills to navigate and input data into established medical software.
• Have general knowledge and understanding of data collection processes.
• Possess strong organizational skills, attention to detail and ability to work with high accuracy.

Grade : 14

• Meet the minimum qualifications above.
• Have five years’ experience with health - related billing processes.

Grade : 15

• Meet the minimum qualifications above.
• Seven years’ experience with health-related billing processes OR
• Hold an associate degree in Health Information Management or related degree.

PI250543275

Last updated : 2024-10-01