Hospital Billing Analyst, Patient Accounting, Bethesda East, FT, 8A-4:30P Remote
About The Position
Responsible for working/editing daily download of assigned Managed Care/HOM claims, optimizing the timely transmittal of accurate and clean claims daily. Billing Specialist I is responsible for identifying and obtaining invalid/missing claim data by communicating with other departments to secure and/or correct the data which prevents claim transmission. Protects payer filing deadlines by utilizing all available resources to resolve held claims and assures all known regulatory, contractual, compliance, and BHSF guidelines are adhered to. Must be willing to take on additional queues as back up to billing all carriers. Utilizes available system resources to resolve claim issues when appropriate, reports any billing system issues to Billing management, and assists other Billing Specialists with claim resolution or other projects as assigned.
Requirements
- High School, Cert, GED, Trn, Exper.
- Prior Commercial and/or Government billing experience required.
- Managed Care/HMO contract billing experience required.
- 3-5 years prior experience in Billing of claims.
- Understanding of all required fields on a 1500 and/or UB for hospitals and diagnostic facilities is required.
- Knowledge and understanding of: Medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD-9/10, CPT-4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, On-line verifications (DDE)
- Internet savvy
- Knowledge of Microsoft Suite a must.
- Extensive analytical skills
- Critical thinking skills
- Detail oriented
- Problem solver
- Good mathematical skills
- Good writing skills
- Good interpersonal skills required.
- Must be able to communicate effectively with other departments in order to resolve pending/missing information on claims to expedite the timely transmission to payers.
- Excellent Time-Management skills.
- Ability to multi-task and work under pressure in order to meet stringent deadlines.
- Minimum Required Experience: 3 Years
Nice To Haves
- AA preferred or equivalent.
- Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus.
- Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims a plus.
Responsibilities
- Working/editing daily download of assigned Managed Care/HOM claims
- Optimizing the timely transmittal of accurate and clean claims daily
- Identifying and obtaining invalid/missing claim data by communicating with other departments to secure and/or correct the data which prevents claim transmission
- Protecting payer filing deadlines by utilizing all available resources to resolve held claims
- Assuring all known regulatory, contractual, compliance, and BHSF guidelines are adhered to
- Taking on additional queues as back up to billing all carriers
- Utilizing available system resources to resolve claim issues
- Reporting any billing system issues to Billing management
- Assisting other Billing Specialists with claim resolution or other projects as assigned
Benefits
- Career growth and development opportunities, with clear pathways and ongoing support
- Comprehensive health and wellness resources that go beyond traditional benefits
- A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
- Tuition reimbursement to support continued learning and advancement
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
