Billing Specialist I – PB Medical Billing
Job Description:
- Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy
- Perform compliant primary/secondary, tertiary and rebill billing functions which can include electronic, paper and portal submission to payers.
- Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission.
- Respond timely to emails and telephone messages as appropriate.
- Communicate issues to management, including payer, system or escalated account issues.
- Participate and attend meetings as requested, training seminars and in-services to develop job knowledge.
- Serve and protect the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards.
- Enhance billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
- Update patient demographics/insurance information in appropriate systems - Monitor claims for missing information, authorization, and control numbers (ICN//DCN)
- Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems.
- Secure needed medical documentation required or requested by third party insurance carriers.
- Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure.
- Perform other related duties as required.
Requirements:
- 1-2 years of medical collections/billing experience
- Basic knowledge of ICD-10, CPT, HCPCS and NCCI
- Basic knowledge of third-party billing guidelines
- Basic knowledge of billing claim forms (UB04/1500)
- Basic knowledge of payor contracts
- Working Knowledge of Microsoft Word and Excel
- Basic working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
- Preferred Qualifications Working knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon
- Working knowledge of DDE Medicare claim system
Benefits: