Billing Representative Revenue Cycle

Ascension•Austin, TX

11h•Remote

About The Position

This role is responsible for determining and verifying insurance coverage and coordination of benefits from all sources for assigned areas. The primary goal is to ensure proper, adequate, and timely billing to ensure prompt payment. This includes confirming insurance coverage, determining the necessity for and obtaining pre-authorization for scheduled procedures, and identifying financial responsibility for services. Patients and/or practitioners will be notified of any services requested or referred that are not authorized by insurance. The role involves communicating with patients and practitioners regarding financial responsibility and insurance coverage issues, maintaining detailed documentation in the patient account record of all billing activities, and documenting claims processed as part of the daily claims reconciliation process. Additionally, the position requires preparing and completing claims for commercial insurance companies, third-party organizations, and/or government or self-payers, as well as researching, analyzing, and reconciling Medicare/Medicaid billing and reimbursement practices. The Billing Representative will also consult with appropriate parties to resolve unbilled claims and review recent accounts for proper billing practices and reimbursement.

Requirements

High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
Required professional licensure/certification can be used in lieu of education or experience, if applicable.

Responsibilities

Determine and verify insurance coverage and coordination of benefits from all sources for assigned area.
Ensure proper adequate and timely billing to ensure prompt payment.
Confirm insurance coverage.
Determine necessity for pre-authorization and obtain authorization for scheduled procedures.
Determine financial responsibility for services to be provided.
Notify patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.
Communicate with patients and practitioners regarding financial responsibility and insurance coverage issues.
Maintain detailed documentation in the patient account record of all billing activities.
Maintain documentation of claims processed as part of the daily claims reconciliation process.
Prepare and complete claims for commercial insurance companies, third party organizations and/or government or self payers.
Research, analyze and reconcile Medicare/Medicaid billing and reimbursement practices.
Consult with appropriate parties to resolve unbilled claims.
Review recent accounts for proper billing practices and reimbursement.