Revenue Cycle Insurance Biller Collector

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.

As our Insurance Biller Collector, you will play a pivotal role in optimizing our revenue cycle management by ensuring the accurate and timely reimbursement of healthcare claims. You will serve as the primary liaison between our facility and insurance providers, leveraging your deep expertise in government and commercial payer guidelines to resolve complex billing discrepancies. By maintaining meticulous records and adhering to strict compliance standards, you will ensure the financial health of our organization while providing exceptional support to our patients and internal stakeholders.

Every day you will manage a high-volume pipeline of accounts receivable, performing daily billing functions and proactively following up on outstanding claims to secure commitment for payment. You will be responsible for navigating the Cerner system to audit claims, submitting precise appeals for denials to maintain consistent cash flow, and documenting all interactions with clarity. Additionally, you will monitor trends in claims processing, troubleshoot insurance inquiries, and collaborate with your team to implement process improvements that streamline our billing workflow.

To be successful in this role, you will need a detail-oriented mindset, strong analytical skills, and a comprehensive understanding of current billing regulations, including UB-04 and HIPAA requirements. You must demonstrate proficiency in managing conflicting priorities, professional communication, and the ability to work independently within a fast-paced environment. By staying current on evolving payer policies and maintaining the highest standards of accuracy, you will contribute significantly to the efficiency and success of our Patient Financial Services (PFS) department.

• Process daily billing for accounts receivable to ensure prompt claims resolution.
• Conduct persistent follow-ups with insurance carriers to secure payment commitments.
• Submit timely appeals for denied claims to maximize revenue recovery.
• Maintain high-quality assurance (QA) and productivity standards as defined by fiscal goals.
• Utilize Cerner and related billing clearinghouse software to document and track account actions.
• Analyze billing trends to identify and address systemic processing issues.

Required:

• Two (2) years of hospital billing/collection experience or relevant healthcare provider claims experience in a high-volume medical environment (including health plan, hospital claims/reimbursement, and appeals experience).
• Demonstrated experience with AHCCCS, Medicare, government, and commercial payer guidelines.
  Proficiency with UB-04 billing requirements and processes.
• High School Graduate or Diploma.
• Previous experience working with computerized billing systems, word processing software, and spreadsheet applications.

Preferred:

• Four (4) years of hospital billing/collection experience or relevant healthcare provider claims experience in a high-volume medical/healthcare remote environment.
• Two years of relevant college education and experience.
• Completion of college-level business courses.
• Hands-on experience with Cerner and various billing clearinghouse platforms.
• Experience utilizing Google Workspace applications for administrative and collaborative tasks.