Job Description:
• 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