38119 Medical Biller - Hospital Claims - Healthcare
About The Position
The Healthcare - Medical Biller is expected to perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims. Must work with other departments to facilitate the meeting of both departmental and facility goals and objectives. Demonstrates an ability to find solutions to problems and keeps management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers. Has an extensive knowledge of billing requirements mandated by payers and / or governmental regulations. This position will perform any and all related job duties as assigned. Individuals must be able to work an eight hour shift between the hours of 8:30 AM CT - 5:30 PM CT, with no remote work initially but opportunity for some hybrid (in office/remote) after training. We will consider individuals open to relocation to San Antonio!
Requirements
- High School Diploma / GED or 3 years of relevant equivalent experience in lieu of diploma / GED.
- 1-3+ years working within the following sectors: healthcare, insurance, business, finance or customer service.
- Working knowledge can be of the following: insurance claims, billing, coding, follow-up, finance, accounting or customer service related responsibilities.
Nice To Haves
- Previous billing background.
- Emphasis in hospital billing
- Excellent communication and interpersonal skills.
- Experience with Excel and Word.
Responsibilities
- Perform all areas of initial billing, secondary billing, and payer audit follow-up for government and non-government claims.
- Work with other departments to facilitate the meeting of both departmental and facility goals and objectives.
- Find solutions to problems and keep management informed of patterns regarding billing edits, compliance issues, payments and or other issues with specific payers.
- Perform daily download and reconciliation of claims from patient accounting system to electronic billing system.
- Transmit or release claims at a minimum daily.
- Work all assigned claims daily by resolving edits, validating claim, or placing on departmental hold by reason.
- Follow-up on all assigned held claims or unreleased claims.
- Bill claims via electronic billing system.
- Review same day and 72 hour admission report to determine if accounts needed to be combined.
- Ensure all address changes and or plan changes are forwarded to the appropriate people so the integrity of the insurance master is maintained.
- File adjusted billings based on audits and or changes in diagnosis or DRG.
- Update patient accounts with corrected demographic or insurance information.
- Work all rejection and payer audit reports within 48 hours of receipt taking whatever action may be required to obtain account resolution.
- Monitor all denials for trends and issues and report findings to supervisor.
- Bill or re-bill as necessary.
- Ensure hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
- Complete assigned special projects within the time frames given.
- Appropriately document electronic billing system and/or patient accounting system.
- Attend training sessions and seminars offered by the Hospital and Third Party Payers.
- Handle all customer calls both internal and external in a professional and courteous manner.
- Return calls and emails as soon as possible, but must be returned within 24 hours.
- Follow the mission statement and values established by the facility.
Benefits
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- Parental Leave
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
