Primary Responsibilities • Meet and exceed all performance standards established by Management. • Responsible for ensuring claims are billed in an accurate and timely manner in accordance with federal and state billing requirements. • Responsible for billing the appropriate third party commercial or government insurance carrier through the effective handling of all billing edits in work queues or daily assignments. • Maintain a strong working knowledge of commercial and governmental insurance billing guidelines and regulations. Seek and maintain knowledge by researching applicable electronic bulletins, reference manuals, or by consulting with insurance representatives. • Maintain a strong working knowledge of payer information as it relates to bundling and unbundling charges, medical necessity and general coding specifications to handle late charges and combine billing. • Maintain a strong working knowledge of how billing processes specific to payer requirements as it relates to 72 hour rules, inpatient readmissions and balance billing patients. • Work with the clinical staff to resolve claim issues. • Monitor and process all research and client (contract) billing to make sure all charges are correct and are being billed to either research/contract and/or patients. • Perform other duties as assigned.
Education • Minimum: High school diploma or equivalent. Experience • Minimum: One year experience in a health care setting (hospital or physician) or experience working for a health insurance company or related organization. • Preferred: Clerical skills with a working knowledge of accounting and insurance coverages and three years of experience in a physician or hospital billing office. Skills/Training • Minimum: PC and keyboarding skills. Working knowledge of 10 key, typing and computers. • Preferred: Knowledge of health insurance billing guidelines. Ability to type/key accurately. Effective verbal, written, and customer service skills.