Analyzing patient accounts, researching account history and determining the appropriate information for billing patients’ third party insurance carriers
Prepares third party billing of Medicare, Medicaid, Blue Cross, Champus, HMO’s, PPO’s, POS’s Workers’ Compensation and Special Contracts
Remain current on changes in billing and payment requirement for all third party payers
Prepare billing for recurrent accounts, Audit treatment and/or encounter dates for Medicare and Medicaid claims to ensure the 72 hr and Lab compliance rules not violated
Analyzes accounts for errors, adjustments and credits, issuing corrected entries when necessary
Updates account information accordingly
Call Insurance Companies and/or patients to obtain missing or necessary information to complete the billing process
Prepares daily, weekly and monthly reports , maintain and monitor 72 hour reports, lab compliance reports, error forms, return mail procedures, productivity reports and other departmental reports

Three (3) years hospital/medical insurance billing experience involving public contact
Proficient PC skills including: Microsoft Word processing, Excel spreadsheet data entry & construction of new data sheets, Access database, Microsoft Outlook, Electronic Billing system, Imaging software and calculator by touch
Strong analytical and problem solving skills, statistical analysis, maintaining intense concentration, and the ability to handle multiple priorities and/or special projects
Knowledge of third party billing procedures as well as state and federal regulations governing billing
Maintains working knowledge of ICD10 and CPT4 codes for specified services rendered
Communication with other hospital departments to clarify coding or charges needed to complete billing process
Mentors and serves as a resource for less experienced staff

Senior Billing Representative – Medicaid

Key skills