JOB SUMMARY:

Responsible for the timely and accurate submission of Insurance claims. Coordinate billing procedures and working payer edits in conjunction with updated Payer requirements and guidelines.

Schedule:

• 1.0 FTE (40 hours)
• Mon-Fri
• 8:00am- 4:30pm

Compensation:

• $23.82/hr+ DOE
• Robust Benefits Package

ESSENTIAL FUNCTIONS, DUTIES, AND RESPONSIBILITIES:

1. Review and check final bills for accuracy according to specific Payer billing requirements.
2. Understand payer edits and update claims appropriately.
3. Understand UB and 1500 billing to apply condition codes, value codes, occurrence codes and patient status codes as required to assure compliant billing to payers.
4. Receive, communicate and assist Supervisor with the implementation of system updates as directed by Payer bulletins and notifications.
5. Process claims daily in the system work queues and Payer clearinghouse for electronic claims processing.
6. Research, prepares, and provides all required reports.
7. Prepares and submits timely adjustments for Managers approval.
8. Prepares timely refunds for Managers approval
9. Knowledge of the medical coding processes including CPT, ICD10 and revenue codes are helpful.
10. Responsible for entering in operating system ,detailed notes indicating the current claim status and documentation of all transactions on assigned accounts.
11. Responsible for being courteous and polite to patients, their agents, coworkers, and other hospital staff at all times, whether on the telephone or in person.
12. Provide quality customer service, both internally and externally.
13. To be cross trained in other areas of the hospital as necessary.
14. Perform other duties as assigned by Manager.

QUALIFICATIONS (Required):

1. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily
2. High School Diploma or GED
3. Preferred, a minimum of two years’ medical billing experience.
4. Minimum of two years’ computer experience which includes Microsoft Word, Excel.
5. Demonstrated ability to be accurate and attentive to detail
6. Analytical and problem-solving skills
7. Excellent communication skills, both written and verbal

ADDITIONAL DESIRABLE QUALIFICATIONS:

1. Mature personality, sense of responsibility, and integrity.
2. Excellent organizational skills and time management skills.
3. Analytical and decision-making skills.
4. Ability to multitask and maintain a flexible daily work schedule.
5. Seek opportunities to provide quality customer service.