NBJI is a growing firm that provides clinical, consultative and research and development services. NBJI is hiring for a bilingual representative, fluent in English and Spanish. The Patient Financial Services Representative is responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims. Processes claims for commercial and compensation payer types (i.e. Workmans compensation, Commercial, Managed Care, Blue Cross, Medicare Medicaid, etc.) and ensures that all assigned claims meet clearinghouse and/or payer processing criteria. Ensures appropriate follow-up on assigned work lists while meeting all departmental productivity and quality review standards. Provides team management with issues regarding the claims follow-up process. Ensures that payer response reports and rejection reports are worked on in a timely and meet departmental productivity and quality review standards. Schedule Monday - Friday (8:00am-5:00pm) Job Responsibilities Ensures that all clean claims are submitted the day they are received, submitted via the appropriate medium, and with all required attachments. Reviews claims, identifies/makes corrections or initiates resolution within 24 hours of the date the claim was received. Documents and reports claims submission issues immediately and provides feedback to team management regarding issues and wins. Provides resolution for pending claims within allowable timeframes, as defined for appropriate deficiency, and/or provides appropriate account follow-up based on established protocol Completes write-off requests and submits to supervisor for daily review. Writes appeals to supervisor for approval. Appropriately documents activity in google spreadsheet/EHR Completes and submits all daily, weekly, and monthly reports with minimal errors. Maintains knowledge of payer requirements, UB-04 standards, and system (i.e. clearinghouse, payer) functionality in addition to NBJI policies and procedures. Ensures documentation is professional, appropriate, accurately depicts actions performed, and is in accordance with departmental quality review standards. May perform additional duties as assigned.
Requirements Experience - Two years of experience in revenue cycle, finance, strong customer service or data analytics Education - High School or GED Language - Must be fluent in English and Spanish
