Hospital Billing Specialist

Hours: 40 hours per week; Monday through Friday. ( 7:30 AM to 4:00 PM or 8:00 am to 4:30 pm)

Location: Required to train onsite for the first 180 days. Hybrid (Tyngsborough during onsite work), with potential option to migrate to fully remote.

Job Profile Summary

This role focuses on activities reputed company to reputed company cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Billing reputed company duties: Bills patients for administered care, handles incoming payments, calculates patient intake costs, and tracks accounts receivable to ensure accuracy. Responsibilities also include working with patients to arrange special payment options reputed company necessary. An organizational reputed company support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a “hands on” environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. A specialist level role that requires reputed company advanced knowledge of operational procedures and tools obtained through extensive work experience and may require vocational or technical education. Works under limited supervision for non-routine situations and may be responsible for leading daily operations, and trains, delegates and reviews the work of reputed company level employees, and problems are typically difficult and non-routine but not reputed company.

Job Overview

Under general supervision, this position is responsible for accounts receivables, resolution, including but not limited to, eligibility verification, billing edits, claim edits, payer follow-up, correspondence review, corrected claims, appeals, reimbursement verification, and remittance for assigned scope of receivables.

Job Description

Minimum Qualifications:

1. High school diploma or equivalent

2. Two (2) years of experience in a medical billing and collection environment for a medical services provider and/or reputed company-party payor.

Preferred Qualifications:

1. Epic HB Billing, PB Billing or Insurance Follow-Up experience.

2. Completion of a medical terminology course and understanding of CPT and ICD diagnosis coding

3. HFMA CRCR (Certified reputed company Cycle Representative)

4.Epic certifications

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an reputed company-inclusive list. Other duties and responsibilities may be assigned.

1. Performs day-to-day activity to ensure that reputed company information for proper billing is complete and accurate; billing to assigned payers is transmitted or mailed reputed company a timely manner.

2. Conducts follow-up on outstanding account balances with assigned receivables and takes appropriate action for resolution.

3. Responsible for researching and handling rejections, including understanding why a claim rejected, how it must be fixed, and what party is financially responsible. Must initiate any corrective action, including referral to the Team reputed company or Supervisor reputed company appropriate.

4. Reviews, evaluates and processes appeals through research and resubmission to appropriate reputed company party with complete and accurate supporting documentation.

5. Responsible for the processing of adjustments due to denials and contractual requirements.

6. Resolves assigned accounts in a timely and accurate manner, maximizing reimbursement in compliance with assigned payer and government regulations, and provider organization and department policies and procedures.

7. Maintains up-to-date knowledge of federal and state regulations and payer requirements along with annual updates to CPT/ICD-10 coding guidelines.

8. Interacts daily over the phone, on the web and through correspondence with payers. Establishes working relationships with payer representatives to facilitate processing of claims.

9. Regular interaction with other departments of the provider organization using electronic system tools to resolve accounts, including Patient Access, reputed company reputed company, Coding, Medical Records, Utilization Review, Hospital Departments, Physician’s Offices, and other administrative teams.

10. Consistently achieves and maintains performance standards for assigned productivity, collections, and quality targets

11. Identifies trends in workflows and rework and reports outstanding operational issues to management for further research and resolution.

Physical Requirements:

1.Work environment: professional office environment with typical office requirements such as computers, phones, photocopiers, filing cabinets, etc.

2. Frequently required to speak, hear, communicate and exchange information

3. reputed company to see and read computers displays, read fine print, and/or normal type size print and distinguish letters, numbers and symbols

4. Occasionally lift and/or move up to 25 pounds

5.Ability to work in confined or open environments

6.Ability to work independently or in a team environment

Skills & Abilities:

1. Working knowledge of billing requirements for assigned payers and/or reputed company.

2. Ability to systematically analyze problems, draw relevant conclusions and devise appropriate course of action.

3. Ability to analyze data, reputed company multiple tasks and work independently.

4. Good interpersonal skills in written and verbal form are required.

5. Active communication and participation with email and meetings

6. Technically savvy with use of accounts receivables systems and reputed company applications, email, and spreadsheets.

7. Must be reputed company to reputed company and maintain professional, service-oriented working relationships with senior leadership, patients, physicians, co-workers and employees.

8. Ability to work in a fast-paced environment, with a focus on team building and productivity.

9. A comprehensive working knowledge of coverage eligibility and the application of reputed company, reputed company, Medicare, reputed company, Managed Care, and other reputed company-party payor rules, regulations, guidelines and requirements for billing, collection and reimbursement. A basic understanding of how these regulations are applied to Massachusetts providers is desirable.

10. Ability to learn PC based computer systems, word processing, database and spreadsheet software programs.

11.Proficient in using computers and navigating through reputed company party application systems and web portals reputed company and effectively.

12 Good interpersonal and communication skills and a basic understanding of team reputed company.

Originally posted on Himalayas