Claims Director jobs in Billings, MT

Claims Director directs and oversees the operations of an insurance claims department to meet operational, financial, and service requirements. Establishes policies and procedures for the administration of insurance claims for personal, property, or casualty loss based on coverage, appraisal, and verifiable damage. Being a Claims Director is responsible for the strategic processing and payment of claims. Maintains up-to-date- knowledge of legislation, regulations, and industry events which pertain to insurance claims. Additionally, Claims Director provides expert guidance and consultation to staff on the most complex claims. Requires a bachelor's degree. Typically reports to top management. The Claims Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)

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Claims Specialty Coder II
  • billingsclinic
  • Billings, MT FULL_TIME
  • This position is eligible for full-time remote and/or telework if located in Montana, Wyoming, Hawaii, Kansas, Minnesota, Michigan, Arizona, or Texas.

    This position may be eligible for a sign-on bonus, tuition loan repayment, and relocation assistance

    Responsible for researching and analyzing coding related pre-bill scrubber edits , denials, and requests for review from Patient Financial services , and ensuring proper coding in compliance with government and third party payer regulations and CPT-4 , ICD, and HCPCs guidelines. Responsible to appeal denials and follow up with payers until the denied claims are paid. Collaborates with multiple departments and participates in review of Recovery Audit Contractor and other government audits and appeals. Provides reports to CBO contacts for trending and research and clarification of coding (ICD, CPT-4/HCPCS) and abstracting of diseases and surgical procedures. Provides education to the CBO teams based on findings .Ensures adherence to all applicable Billings Clinic Central Business Office and regulatory compliance policies and procedures governing medical records coding, insurance billing and reimbursement methodologies

    Essential Job Functions

    • Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
    • Performs all other duties as assigned or as needed to meet the needs of the department/organization.
    • Researches, analyzes, and appeals government and third party payer coding related denials of service based on explanation of benefits and remittance advice information and/or patient requests. Identifies trends/patterns that could pose a compliance risk or reimbursement issue and reports them to CBO Coding Management and CBO Coding Advisor for coding and documentation education, trending, and monitoring.
    • Researches, analyzes, and resolves government and third party payer coding related per-bill scrubber edits.
    • Identifies and reports any regulatory or compliance concerns to Coding Resources Manager.
    • Monitors coding related audit activity in the organization’s tracking tool. Works in conjunction with the Clinical Coding Specialist and Coding Advisors to review of all coding related external audits determinations. Apply clinical and coding assessment skills to medical record, and extract supportive documentation for appeals. Report any issues to the department managers and compliance team. Provide clinical documentation education to appropriate staff and physicians. Communicate with outside agencies when necessary to clarify issues.
    • Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements

    Minimum Qualifications

    Education

    • High School or GED

    Experience

    • Minimum Two years experience in a multi-specialty clinic and/or hospital working with ICD-CM, CPT-4, HCPCS, DRG coding
    • Previous demonstrated experience in a clinical setting performing technical responsibilities related to ICD-CM, CPT-4/HCPCS, DRG coding, fees and reimbursement
    • Demonstrated ability to understand and develop information using databases and creating complex spreadsheets. Intermediate knowledge of Microsoft Office products, including Word, Excel and PowerPoint.
    • Prior training in anatomy, medical terminology and coding
    • Or an equivalent combination of education and experience relating to the above tasks, knowledge, skills and abilities will be considered

    Certifications and Licenses

    • Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or other AHIMA or AAPC recognized credentials required.

  • 25 Days Ago

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Claims Specialty Coder II
  • Billings Clinic Health System
  • Billings, MT FULL_TIME
  • This position is eligible for full-time remote and/or telework if located in Montana, Wyoming, Hawaii, Kansas, Minnesota, Michigan, Arizona, or Texas. This position may be eligible for a sign-on bonus...
  • 1 Month Ago

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Claims Specialty Coder II
  • Billings Clinic
  • Billings, MT FULL_TIME
  • You’ll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the...
  • 1 Month Ago

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Claims Specialist I (Full-time/Billings)
  • Billings Clinic Health System
  • Billings, MT FULL_TIME
  • The Claim Specialist’s main focus is to obtain maximum and appropriate reimbursement for all claims from government and third party payers. The Claims Specialist is responsible for preparing and submi...
  • 22 Days Ago

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Claims Specialist I (Full-time/Billings)
  • billingsclinic
  • BILLINGS, MT FULL_TIME
  • The Claim Specialist’s main focus is to obtain maximum and appropriate reimbursement for all claims from government and third party payers. The Claims Specialist is responsible for preparing and submi...
  • 24 Days Ago

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Claims Specialist I (Full-time/Billings)
  • Billings Clinic
  • Billings, MT FULL_TIME
  • You’ll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the...
  • 2 Days Ago

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0 Claims Director jobs found in Billings, MT area

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L&D RN
  • TotalMed
  • Billings, MT
  • We are seeking a Registered Nurse-Labor and Delivery for a travel assignment in Billings Montana.
  • 3/28/2024 12:00:00 AM

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Branch Insurance Agent Earn Up to 15% in Commissions
  • AAA Northern California, Nevada & Utah
  • Billings, MT
  • JOB DESCRIPTION We call our club's vision, mission, values, and supporting pillars "Our House" because they are the foun...
  • 3/28/2024 12:00:00 AM

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Cashier
  • Buffalo Wild Wings
  • Billings, MT
  • Buffalo Wild Wings has an atmosphere that creates stories worth telling - for our guests and for our team members. Yes, ...
  • 3/28/2024 12:00:00 AM

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Delivery Representative
  • UGI Corporation
  • Billings, MT
  • The hourly rate starts at $26.75, depending on circumstances including an applicant's skills and qualifications, certain...
  • 3/28/2024 12:00:00 AM

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Hydraulics Project Engineer
  • Impact Recruitment
  • Billings, MT
  • Impact Recruitment is currently looking for a Hydraulics Project Engineer eager for an opportunity to join an award-winn...
  • 3/28/2024 12:00:00 AM

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Remote Sales - Insurance Agent
  • The Sudhoff Agency
  • Billings, MT
  • Are you looking to take your career in a new direction, or are you already a licensed insurance agent? At The Sudhoff Ag...
  • 3/27/2024 12:00:00 AM

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INSURANCE AGENT - REMOTE
  • The Gardner Agency Group
  • Billings, MT
  • Are you looking to take your career in a new direction or are you already a licensed insurance agent? At The Gardner Age...
  • 3/27/2024 12:00:00 AM

3
Licensed Insurance Agent (Remote)
  • 360 Benefit Solutions - Frazier
  • Billings, MT
  • Outside sales with a leading organization representing a multi carrier portfolio of products in the Health, Life, Senior...
  • 3/25/2024 12:00:00 AM

Billings is the largest city in the U.S. state of Montana, with a population estimated at 109,642 as of 2017. Located in the south-central portion of the state, it is the seat of Yellowstone County and the principal city of the Billings Metropolitan Area, which has a total a population of 170,498. It has a trade area of over 500,000. Billings was nicknamed the "Magic City" because of its rapid growth from its founding as a railroad town in March 1882. The city is named for Frederick H. Billings, a former president of the Northern Pacific Railroad. With one of the largest trade areas in the Uni...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Director jobs
$176,416 to $255,136
Billings, Montana area prices
were up 3.1% from a year ago

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