Travel Billing Specialist III - Hospital Rev Cycle - Remote Work Schedule

Responsibilities

• Prepares and processes eligible billing claims for travel services.
• Reviews and adjusts accounts to ensure accurate and thorough processing of these claims.
• Ensures high quality, timely completion of work, accurate data entry, efficient processes, and positive working relationships among supervised employees, including internal and external patients/clients.
• 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, achieving and maintaining 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 third-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

• Knowledge of electronic medical record systems.
• Knowledge of ICD-10 and CPT coding.
• Knowledge of medical insurance process.
• Knowledge of alternative health resources.
• Knowledge of customer service concepts and practice.
• Knowledge of basic medical terminology and clinic systems.
• Knowledge of the Privacy Act of 1974 and HIPAA Privacy Rule Act of 1966.
• Knowledge of state, federal, and tribal health care programs.
• Knowledge of state, federal, and public/private insurance, including Medicaid/Medicare.
• Non-supervisory - Four (4) years of accounting, billing, insurance, medical claims care office or related experience.