Hospital Biller

Johnson County Hospital•Tecumseh, NE

2d•Onsite

About The Position

The Hospital Biller is responsible for posting and managing account payments, submitting insurance claims, and following up with insurance companies. This role requires handling demands pleasantly, professionally, and efficiently. The position involves reviewing health record documentation, applying appropriate CPT and HCPCS codes, preparing and submitting claims, and resolving claim rejections and denials. The Biller will also post insurance payments, manage patient billing and collections, and communicate with healthcare providers, patients, and insurance representatives. A strong understanding of HIPAA regulations and hospital policies is essential.

Requirements

Knowledge of insurance rules and guidelines including Medicare, Medicaid, managed care plans, commercial plans and other third-party payers.
Handle confidential patient information with professional discretion.
High School Diploma
Knowledge of medical terminology and billing regulations
Billing experience desired
Computer knowledge and data entry skills
Good business communication skills
Knowledge of professional telephone techniques and patient relations
Ability to work in a busy, fast-paced office environment

Responsibilities

Posting and managing account payments.
Submitting insurance claims and following up with insurance companies.
Reviewing health record documentation to identify treated conditions and billable services.
Applying and knowing appropriate CPT codes and HCPCS codes.
Preparing paper and electronic claims for submission.
Requesting missing patient information.
Transmitting and processing all billable claims.
Reviewing EMR and clearinghouse claims rejections.
Analyzing and resolving claim rejections and denials.
Calling insurance companies to inquire about claim status.
Reviewing, appealing, and attaching necessary documentation on claims.
Reviewing, modifying, documenting denial reason codes, correcting, and regenerating denied claims.
Utilizing assigned reports to process denials within a 45-day timeframe.
Reviewing insurance payments for accuracy.
Responding to questions and complaints from patients or insurance companies.
Posting all insurance checks, EFTs, and credit cards daily.
Maintaining organized documentation of all billing correspondence.
Reviewing requested insurance refunds for accuracy and submitting them for processing.
Reviewing patient statements for accuracy, completeness, and obtaining missing information.
Sending statements to patients daily.
Reviewing self-pay credit balances for accuracy and submitting patient refunds.
Managing accounts for patient payments or collections.
Working with the hospital's collection agency on delinquent accounts.
Contributing to team effort by accomplishing results timely.
Communicating with health care providers, patients, insurance claim representatives, and other parties to clarify billing issues and facilitate timely payment.
Consulting supervisor, team members, and appropriate resources to solve billing and collection questions and issues.
Performing other duties as assigned.
Understanding and demonstrating compliance with HIPPA regulations.
Complying with all JCH policies and procedures.