Billing Representative - Level 1 (53152)

Performance Home Medical•Houston, TX

1d•Onsite

About The Position

Performance Home Medical has been a leader in providing quality products and services since 1995. At Performance Home Medical, our patients come first. Using the latest technology and best clinical support, we help our patients take control of their conditions and live longer and healthier. Position Summary: The Billing Representative (Level 1 – Medicare & Private Insurance, Insurance Changes) plays a critical role in ensuring the accurate and timely processing of patient billing and collections. This position is responsible for managing documentation, resolving denials, auditing accounts, and maintaining compliance with insurance, state, and federal regulations. The ideal candidate brings a strong understanding of payer guidelines, HIPAA regulations, and company policies. In addition, they manage designated tasks and reportings to support a seamless reimbursement process. Additionally, the Billing Representative responds to billing inquiries, adjust balances, and assist with internal and external audits to uphold performance standards and key metrics. This role is part of the Billing Representative job family, which includes levels 1-5. Advancement is based on demonstrated competencies and business needs. Level 1 – Medicare & Private Insurance, Insurance Changes

Requirements

Associate degree (A.A.) or equivalent from two-year college or technical school; or six months to one-year related experience and/or training; or equivalent combination of education and experience.
Knowledge of home medical equipment
Basic knowledge of medical terminology/ICD codes preferred.
Type at least 40 words per minute with no errors
Organizational skills
Read and interpret complex documents.
Respond effectively to sensitive inquiries.
Addition, Subtraction, Multiplication, and Division.
Work with whole numbers, decimals, and fractions.
Knows times tables and how to calculate change, prices, or totals.
Apply common sense understanding to carry out detailed but uninvolved written or oral instructions.
Deal with problems involving a few concrete variables in standardized situations.
Fluency in Microsoft Office (Word, Outlook, Chrome, Internet Explorer, SharePoint)
Traveling as needed within region/territory.
Have reliable means of transportation.
Meet requirements of our Motor Vehicle policy.

Nice To Haves

Basic knowledge of medical terminology/ICD codes preferred.

Responsibilities

Answer billing and collection questions for patients, referral sources, and coworkers.
Assist PHM’s billing and collections services with denials.
Maintain and request documentation required to meet continued billing requirements.
Audit account for accuracy and adjust balances as needed.
Maintain and request on-going authorizations when required to assure flow of revenue.
Maintain a high level of knowledge and understanding of the insurance guidelines for all payers within the PHM designated patient base.
Maintain a current knowledge of HIPAA privacy laws and regulations.
Work designated tasks and reports to maintain all avenues of reimbursement flow smoothly.
Perform internal and external audits to ensure insurance plan guidelines as well as State and Federal Regulations were met.
Meet key performance metrics.
Follow insurance plan guidelines as well as State and Federal Regulations.
Complies with all applicable company policies and procedures.
Monitors and records client, physician, and referral source communications.
Notifies appropriate personnel if a service or response, within the scope of their responsibilities, is required.
Assists with the implementation of performance improvement program to meet company, state, federal, and accreditation standards.
Always maintains patient confidentiality according to company policy.