Billing Services Representative

Responsibilities

• Ensure account accuracy
• Review daily claims to ensure submissions are clean and timely
• Monitor charges, modifiers, CPT-4s, HCPCS, payments, DRGs, and ICD-10 coding
• Review outstanding accounts using ATB/queues, payments reports, halt report, electronic billing edits, and credit balances
• Submit timely and accurate adjustments, notes, patient balance transfers, and medical record requests
• Work with management team and notify of issues that arise with payors, departments, etc.
• Resolve account issues and problem-solve independently whenever possible
• Use technology provided (including hospital information system, contract management system, electronic billing system, payer websites, and document imaging system)
• Manage denials and appeal administrative claims
• Understand denials and how they should be handled
• Send clinical denials and downgraded claims to appropriate parties to ensure timely appeal
• Ensure claims denied at time of billing are distributed to appropriate parties for review
• Update and correct accounts with assistance of originating departments (charges, authorizations, insurance issues)
• Follow departmental and hospital policy and procedure (including HIPAA guidelines and Federal guidelines)
• Understand payor contracts and billing guidelines; revenue codes and payor-specific requirements; and payor/plan codes
• Knowledge of Medicare and Medicaid requirements

Requirements

• One (1) or more years experience as a Medical Insurance Biller or related responsibilities; hospital billing strongly preferred
• Proficient in Microsoft Word and Microsoft Excel
• High level of interpersonal skills necessary to lead others and work effectively with Patient Accounts Personnel as well as outside agencies
• Comprehensive knowledge of Collection, A/R follow-up, and Billing
• Knowledge of third-party payers, State and Federal Agencies (constantly changing) with regards to Patient Accounting
• Ability to consistently meet deadlines, concentrate, and pay attention to details 75% of work time

Pay

Salary range: $18.47 – $28.61 per hour. Competitive base rates determined by job-related work experience, internal equity, and industry-specific market data. Some positions may be eligible for clinical certification pay and shift differentials. The salary range listed for exempt positions reflects full-time compensation and will be prorated based on employment status.

Benefits

• Medical, dental, and vision insurance
• Savings accounts
• Voluntary benefits
• Wellness programs and discounts
• Paid life insurance
• Generous 401(k) match
• Adoption assistance
• Back-up daycare
• Free onsite parking
• Recognition rewards
• Fully paid tuition program or generous tuition assistance program