Hospital Billing Representative II

ChristianaCare•Wilmington, DE

12d•$23 - $34•Onsite

About The Position

This role is responsible for the collection of insurance accounts receivable, including reporting, analysis, dispute resolution, appeals, and reconciliation of acute hospital/facility claims. The position involves reviewing and submitting UB-04 forms, following up with insurance representatives, submitting necessary documentation, and reviewing payment vouchers for accuracy. The representative will collaborate with various departments and payer representatives to resolve claim denials and provide trend analysis to management. Additionally, the role requires writing and submitting appeals for incorrectly denied claims, working rejection and late charge reports, and utilizing specific billing systems like Soarian/Cerner and ePremis, as well as external payer sites.

Requirements

High school graduate or equivalent required
Demonstrated strong verbal and written communication skills.
Strong organizational and communication skills.
Ability to multi-task, self-direct, work independently and with team and team leads.
Data entry; Soarian and ePremis navigation.
Working knowledge of Microsoft applications, such as Word and Excel.
Knowledge of hospital billing and reimbursement policies and procedures.
Skill in written and oral communication.
Ability to act independently within established guidelines.
Ability to multitask, prioritize and manage high volume tasks.
Ability to exercise judgement and tact.

Nice To Haves

Associate’s Degree preferred.
1-3 years of experience in A/R processes preferred, ideally within a hospital billing setting.
Soarian, Power Chart, and ePremis experience preferred.

Responsibilities

Reviews and submits UB-04 forms to insurance companies.
Performs follow-up with insurance representatives to obtain claim status, payment and to resolve claim discrepancies.
Submits itemized bills, medical records and corrected claims as needed.
Reviews payment vouchers to ensure proper reimbursement.
Interacts directly with department staff, Revenue Integrity, HIMS, and payer representatives to evaluate and resolve line level denials.
Provides trend analysis to management, leadership, and insurance liaisons.
Writes and submits appeals when claims deny incorrectly.
Works rejection and late charge reports.
Utilizes the Soarian/Cerner billing system for AR and denial reporting.
Utilizes ePremis for clean claim review and transmission.
Accesses external payer sites for payer policies and claim disputes.
Performs other related duties as required.