Key skills
R
About this role
Role Overview
- Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing
- Secures needed medical documentation required or requested by third party insurances
- Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains
- Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers
- Responsible for consistently meeting production and quality assurance standards
- Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer
- Updates job knowledge by participating in company offered education opportunities
- Protects customer information by keeping all information confidential
- Processes miscellaneous paperwork
- Ability to work with high profile customers with difficult processes
- May regularly be asked to help with team projects
- Ensure all claims are submitted daily with a goal of zero errors
- Timely follow up on insurance claim status
- Reading and interpreting an EOB (Explanation of Benefits)
- Respond to inquiries by insurance companies
- Denial Management
- Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles
- Review late charge reports and file corrected claims or write off charges as per client policy
- Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy
- Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer
Requirements
- 3 years of recent Critical Access or Acute Care facility and professional claim billing
- Meditech E.H.R Experience Required
- Computer skills
- Experience in CPT and ICD-10 coding
- Familiarity with medical terminology
- Ability to communicate with various insurance payers
- Experience in filing claim appeals with insurance companies
Benefits
- Competitive salary
- Flexible working hours
- Professional development opportunities