Claims Billing Rep

Overview

This position is accountable for processing all third party claims for payment on assigned inpatient and outpatient accounts through a computerized editing system in a timely and accurate manner to reduce accounts receivable days, including serving as a resource regarding insurance related questions.

Talent Pool: Professional and Corporate Services

Responsibilities

Process third party claims for payment on assigned patient accounts to assure prompt claim filing electronically and/or paper. Ensures accuracy of charges by working all claim related edits and processing claims to meet all regulations, policies and guidelines. Ensures that all attachments to be submitted with claims are submitted correctly and timely to ensure maximum reimbursement.--------------------------------------------------Completes billing claim edits in an accurate and timely manner by ensuring all claims are billed daily and not to exceed more than a 3 day window.--------------------------------------------------Ensures thorough, concise, and up-to-date documentation is maintained. --------------------------------------------------Maintain current working knowledge of changes in health care reimbursements. Attends seminars and weekly staff meetings. Follows all Corporate Compliance Rules and Regulations. Follows all HIPAA regulations without exception.--------------------------------------------------Maintain acceptable level of quality and production standards as determined by supervisory review and audit of assigned account categories. Notifies manager of possible or potential issues that may result in delays in payments or increase of denials. --------------------------------------------------

Qualifications

EDUCATION:High School Diploma or equivalent, RequiredAssociates, PreferredHigh School Diploma or its equivalency required; two years of college preferred. EXPERIENCE:3, Required4-5, PreferredMinimum of 3 years billing experience in hospital, clinic or medical business office required; 4 to 5 years preferred. LICENSURE/CERTIFICATION/REGISTRY/LISTING:REQUIREDN/APREFERREDN/A