Transplant Billing Representative

Transplant Billing Representative

As a Transplant Billing Representative, you will manage a designated portfolio of inpatient and outpatient transplant accounts, ensuring accurate claim preparation and timely reimbursement. Your primary responsibilities include:

• Reviewing and preparing inpatient and outpatient transplant claims based on payer type and billing requirements
• Submitting claims to commercial, government, and self-pay payers in compliance with billing regulations and timely filing guidelines
• Editing claims to ensure accurate coding, documentation, and payer-specific requirements are met prior to submission
• Reviewing required documentation such as authorizations, medical records, and transplant-related invoices to support claim accuracy
• Managing assigned transplant accounts, including mid-to-high dollar balances, and responding to payer inquiries to support timely resolution

Salary Range: $26.79 - $38.05/hourly

We are seeking a detail-oriented individual with:

• High school diploma or GED; Minimum of 3 years of related hospital billing or collections experience, including at least 1 year in billing investigation
• Associate's degree in healthcare administration, finance, or a related field, preferred
• Knowledge of inpatient and outpatient hospital billing processes and claim submission requirements
• Ability to interpret payer billing rules and basic contract terms
• Working knowledge of UB-04 claim forms, CPT codes, HCPCS codes, and hospital billing data elements
• Experience using patient accounting or billing systems in a healthcare setting
• Proficiency in Microsoft Office, especially Excel and Word
• Strong organizational skills, attention to detail, and the ability to manage multiple accounts while meeting productivity expectations