Senior Revenue Cycle Billing Specialist - FT - Day - MSO/Centralized Billing Lawrenceville NJ

About the role

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Responsibilities

• Acts as a front-line resource for staff inquiries, coaching, and training as it pertains to the healthcare claim submission life cycle.
• Has a strong understanding of all essential functions within billing department and can articulate and disseminate information to staff timely and effectively.
• Supports billing management and work focused projects, as well as provide feedback.
• Responsible for all aspects of claim submission for services rendered at Capital Health through the Revenue Cycle life cycle to all payers, including but not limited to pre and post claim review, claim (277) rejections, denial review, and claim resubmission.
• Provides, elicits, and gathers information to facilitate, expedite, and obtain professional payments from third party carriers.
• Performs collection and follow-up activity with insurance companies.
• Completes necessary billing projects as assigned.
• Maintains current knowledge of payer requirements.
• Works closely with appropriate staff/departments to make corrections and ensures accuracy for the days’ work (ex: coding and patient access: CCI edits, Medical Unlikely edits, demographic information, date of birth, etc).
• Verifies covered days (hospital) and services to be rendered (hospital/professional) prior to submitting claims in a timely manner.
• Corrects errors from the daily claim (277) rejections or escalates to the appropriate department for resolution.
• Reviews hospital billing reports for corrections needed in order to have the accounts final bill – these include but are not limited to: Late Charge report, 72-hour report, etc. to ensure claims are billed timely and accurately (hospital only).
• Evaluates, reviews, and analyzes patient accounts to determine if third party payments have been received, recorded, and are appropriate based on contractual expectations.
• Identifies and communicates payment variances, error trends, and account issues for resolution to management.
• Reviews credit balances for adjustments, refund and/or claim adjustment submission as assigned.
• Researches and retrieves appropriate documentation (e.g. authorizations, medical records) for appealing denials.
• Works correspondence as assigned and escalated by correspondence team.
• Communicates denials and other issues with the appropriate Revenue Cycle department and/or physician representative to address root causes.
• Demonstrates willingness to adapt to changing departmental demands as new billing duties are required.
• Completes special assignments and projects with minimal supervision and consistently meets targets.
• Maintains assigned productivity standards and escalates obstacles in accomplishing expectations in a timely manner.
• Prioritizes and updates files and other required documentation in accordance with established policies, guidelines, and procedures.

Requirements

• Education: High school diploma or equivalent.
• Experience: Three years' previous healthcare billing experience in a hospital, professional, or medical office setting.

Qualifications

• Special Training: Intermediate knowledge of Microsoft office products, specifically word and excel. Proficient experience using Electronic Medical Record (EMR) software. Cerner, Athena, Epic preferred.

Skills

• Intermediate knowledge of Microsoft office products, specifically word and excel.
• Proficient experience using Electronic Medical Record (EMR) software. Cerner, Athena, Epic preferred.

Benefits

Medical Plan
Prescription drug coverage & In-House Employee Pharmacy
Dental Plan
Vision Plan
Flexible Spending Account (FSA)
Healthcare FSA
Dependent Care FSA
Retirement Savings and Investment Plan
Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
Insurance
Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
Disability Benefits – Long Term Disability (LTD)
Disability Benefits – Short Term Disability (STD)
Employee Assistance Program
Commuter Transit
Commuter Parking
Supplemental Life Insurance
Voluntary Life
Spouse Voluntary Life
Employee Voluntary Life
Child Voluntary Life
Voluntary Legal Services
Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
Voluntary Identity Theft Insurance
Voluntary Pet Insurance
Paid Time-Off Program

Pay

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.

Schedule

Usual Work Day: 8 Hours