Billing Associate - AHN Cancer Institute / Radiation Oncology - Forbes

Highmark Health•Monroeville, PA

About The Position

This job processes pro-fee billing activities. It involves posting co-payments, patient payments, and insurance company payments (paper and electronic), as well as denials. The role also includes reconciliation of payments and preparation and deposit of received payments. Additionally, it requires using CPT, ICD-9, and payer specific codes and modifiers to prepare and enter charges for office, hospital, and outpatient services. The associate will assist customers with patient billing inquiries, identify unpaid balances (insurance and patient) through A/R reports and take appropriate actions, and obtain and enter patient demographic, insurance, and referral/precertification information in the billing system. Verification of insurance information via hospital and insurance carrier systems and ensuring timely submission of electronic and paper claims to insurance carriers are also key responsibilities. Maintaining current knowledge of federal and state reimbursement policies/regulations and system policies pertaining to billing, ensuring compliance with regulatory requirements, and performing all other duties as assigned, including supporting front-end office processes, are also part of the role.

Requirements

Minimum High school diploma or GED; or one to three months related experience and/or training; or equivalent combination of education and experience.
1-3 years’ healthcare billing experience.

Nice To Haves

Graduate of a medical billing program.
Medical Records training and OASIS education.

Responsibilities

Posts co-payments, patient payments, and insurance company payments (paper and electronic), and denials.
Performs reconciliation of payments.
Prepares and deposits payments received.
Uses CPT, ICD-9, and payer specific codes and modifiers to prepare and enter charges for entry (includes office, hospital, and outpatient charges).
Assists customers with patient billing inquiries.
Identifies unpaid balances (insurance and patient) through A/R reports and takes appropriate actions.
Obtains and enters patient demographic, insurance, and referral/precertification information in the billing system.
Verifies insurance information via hospital and insurance carrier systems.
Ensures that electronic and paper claims are sent to insurance carriers in a timely manner.
Maintains current knowledge of federal and state reimbursement policies/regulations and system policies pertaining to billing.
Ensures compliance with regulatory requirements.
Performs all other duties as assigned, including but not limited to supporting front end office processes.