Billing Rep (Revenue Cycle), On Campus

About the role

The Billing Representative submits hospital or professional claims to Payers including Medicare, Medicaid, Managed Medicare, Managed Medicaid, Managed Care, Commercial, Workers Compensation, and Champus/Tricare.

Responsibilities

• Perform code and demographic audits on paper and electronic claims.
• Use the billing scrubber, payer edits, and custom edits for accuracy.
• Communicate specific problems or concerns to Manager as appropriate.
• Review electronic claims transmission reports.
• Resolve ECS rejections by correcting them in the system and resubmitting for payment.
• Request or post charge corrections and appropriate credit and debit adjustments to patient accounts.
• Correct patient demographic information when new/correct information is received.
• Review claims for accuracy and completeness and obtain any missing information.
• Identify and bill secondary or tertiary insurances as needed.
• Work rejected claims utilizing compliant and ethical billing practices.
• Performs other duties as assigned or requested.

Qualifications

• H.S. Diploma/GED Equivalent
• Less than 1 Year of Experience
• Workers Comp claims experience a plus.
• Epic (Resolute HB or PB) knowledge
• Identifying and resolving claim denials