Job Description

Summary:

Responsible for monitoring billing processes and makes corrections as needed. Manages the timely and accurate posting of charge data for both patient and client-billed accounts. Identifies, corrects, and maintains appropriate billing data within the information system. Ensures all claims billed meet government mandated procedures for Integrity and Compliance. Resolves insurance claim errors and regulatory edits related to billing. Handles customer billing inquiries. Serves as a resource for billing and compliance activities.

Responsibilities:

• Researches, identifies and submits appropriate coding/billing requests
• Acts as the technical expert
• Performs pre-submission audit of coding/documentation and monitoring of activities to ensure compliance billing and internal standards are met in accordance with national reimbursement agencies' standards and regulations (Medicare/Medicaid).
• Maintains knowledge of all insurance/payer billing requirements
• Identifies trends in billing issues, system issues and payer specific requirements.
• Maintains knowledge of the Meditech computer system and the electronic billing system, and ensures that system features are used effectively to support billing activity.
• Audits and reconciles each department to ensure all billable services/items are charged appropriately.
• Maintains Charge Master files and routinely reviews professional and technical charges updating per compliance guidelines.
• Identifies opportunities to recoup and prevent potential future loss of billing revenue.
• Provides technical support to the hospital's coding team to ensure accurate coding and billing.
• Performs other duties as assigned.

Requirements:

• High School Diploma

Position Responsibilities

• Translate CPT/ICD 10 coding. Resequencing of ICD 10 codes as provided in the orders to accurately submit clean claims.
• Work with insurance companies to submit claims and follow up on payments. Submit insurance claims and follow up on unpaid, rejected, or denied claims to resolve and resubmit when required
• Collaborating with patients or customers, third party institutions and other team members to resolve billing inconsistencies and errors
• Ability to meet status quo in daily task performance.

Requirements:

Education/Skills

• Strong organizational skills and attention to detail.
• Excellent communications and customer service skills.
• Problem-solving and analytical skills.
• Ability to work independently and as part of a team.

Experience

• Minimum of 5 years medical/laboratory billing experience.
• Knowledge of medical terminology, coding systems (ICD, CPT), and insurance billing practices.
• Proficiency in using billing software and EHR systems.

Work Type:

Full Time

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