Commercial Insurance Billing and Follow Up
About The Position
Responsible for accurately and efficiently processing claims and invoices. This role involves managing the billing for commercial insurance and managed care payers, performing billing functions to review and resolve errors for clean claim submissions, and utilizing resources to verify eligibility, benefits, and claim status. The position requires good judgment for account resolution, clear documentation of all activity, and maintaining claims tracking for specific programs. It also involves providing departmental support, assisting with special projects, and demonstrating excellent customer service skills in handling calls and providing information. The role requires advising team leads and supervisors of billing errors, payer trends, denials, or payment fluctuations, and adhering to all Hospital Regulations associated with Compliance (including HIPAA).
Requirements
- Prior billing experience a must.
- Excellent customer service skills
- Problem solving skills
- Strong analytical skills
- Strong organizational skills
- Ability to interact with varying cultures and a diverse population
- Basic computer skills
Nice To Haves
- Bi-lingual in Spanish preferred
- 1-2 years’ experience in a customer relations driven industry preferred
Responsibilities
- Prepare bills and invoices for medical services and treatments received
- Manage the billing for commercial insurance and managed care payers
- Perform billing functions to review and take necessary actions to resolve billing errors ensuring clean claim submissions
- Utilize all resources available, including electronic inquiries to verify eligibility, benefits and claim status
- Exercise good judgement toward account resolution and documents all activity on an account in a clear, accurate and consistent manner utilizing appropriate online system
- Maintain claims tracking for the worker’s compensation and motor vehicle billing program
- Provide support for the department and assist with special projects, as assigned
- Demonstrate excellent customer service skills when responding to incoming or outgoing calls in a most courteous manner providing clear and appropriate information as needed
- Advise team lead and/or supervisor of any billing errors, payer trends in claims processing, denials or payment fluctuations, to ensure proper handling and escalation as necessary
- Adhere to all Hospital Regulations associated with Compliance (to include HIPAA, etc.)
- Performs other duties as assigned.
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What This Job Offers
Career Level
Entry Level
Education Level
High school or GED
