Travel Billing Specialist I - Hospital Rev Cycle - Remote/Hybrid Work Schedule

Responsibilities

• Ensures high quality, timely completion of work, accurate data entry, efficient processes and positive working relationships among the supervised employees to include internal and external patient/clients.
• Requires strong analytical and business skills to set up and manage all aspects of billing systems according to Medicare, Medicaid, and Private Insurance.
• Processes and prepares business and government forms.
• Manages all electronic claims entry and processes.
• Investigates all denied claims and edits for re-submission.
• Performs quality assurance testing on all EMR programs to ensure accurate processing and compilation of data for required payers.
• Affirms timely billing and collections, achieve and maintain a collection rate of less than 30% with A/R of 60 days or greater.
• Researches billing and coding requirements for new services as directed by Financial Operations Manager.
• Maintains strong working knowledge of coding and changes in coding and modifiers.
• Consults with Providers to resolve or clarify codes and diagnoses with conflicting, missing or unclear information.
• Creates and edits templates and codes in the EMR system as directed by Providers.
• Maintains Electronic Data interchange (EDI) systems for services.
• Reviews, prepares and submits claims to all 3rd party payers.
• Identifies appropriateness of billable charges.
• Determines Primary Payer when more than one is listed.
• Provides documentation and/or reports with claims when necessary.
• Identifies every billable expense and increases revenue in the most efficient and timely manner by preparing and submitting insurance claims and reviewing and adjusting accounts to ensure accurate and timely payments.
• Prepares monthly aging reports.
• Maintains strong knowledge of referral and claim processing software, master files and interface conversion tables.
• Performs other duties as assigned.

Qualifications

• A high school diploma or GED equivalent.
• Non-supervisory – One (1) year experience in the medical office experience involving medical billing.