Revenue Cycle Billing Specialist - FT - Day - Hospital Billing Lawrenceville NJ

divh2Capital Health Billing Specialist/h2pCapital Health is the regions leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region./ppCapital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates./ppThe listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time)./pp$19.32 - $24.13/ppScheduled Weekly Hours: 40/ph3Position Overview/h3pResponsible for all aspects of claim submission for services rendered at Capital Health through the Revenue Cycle life cycle to all payers, including but not limited to pre and post claim review, claim (277) rejections, denial review, and claim resubmission. Provides, elicits, and gathers information to facilitate, expedite, and obtain professional payments from third party carriers. Performs collection and follow-up activity with insurance companies. Completes necessary billing projects as assigned. Meets internal and external customer expectations./ph3Minimum Requirements/h3pEducation: High school diploma or equivalent./ppExperience: One year previous healthcare billing experience in a hospital, professional, or medical office setting./ppOther Credentials: Knowledge and Skills: Special Training: Working knowledge of Microsoft office and excel. Experience using Electronic Medical Record (EMR) software. Cerner, Athena, Epic preferred./ppMental, Behavioral and Emotional Abilities: Can work well independently and in team settings./ph3Essential Functions/h3pResponsible for all primary and secondary claims submitted to payers according to insurance requirements./ppAnalyzes claims for errors during all stages of submission for accuracy of billing./ppMaintains current knowledge of payer requirements./ppDemonstrates comprehensive understanding of team functions and specialized terminology of third-party payers./ppWorks closely with appropriate staff/departments to make corrections and ensures accuracy for the days work (ex: coding and patient access: CCI edits, Medical Unlikely edits, demographic information, date of birth, etc)./ppResolves all Return to Provider (RTP) claims in error in the Medicare Fiscal Intermediary Shared System (FISS) on a daily basis (hospital only)./ppResolves New Jersey Discharge Data Collection System (NJDDCS) MIDS errors on a routine basis as defined by management (hospital only)./ppVerifies covered days (hospital) and services to be rendered (hospital/professional) prior to submitting claims in a timely manner./ppCorrects errors from the daily claim (277) rejections or escalates to the appropriate department for resolution./ppReviews hospital billing reports for corrections needed in order to have the accounts final bill these includes but are not limited to: Late Charge report, 72-hour report, etc. to ensure claims are billed timely and accurately (hospital only)./ppEvaluates, reviews, and analyzes patient accounts to determine if third party payments have been received, recorded, and are appropriate based on contractual expectations. Review patients account in totality, including demographic information, service rendered, insurances documentation, etc to gain full understanding of the patients A/R./ppPerforms appropriate follow-up which could include calls to payers, claim review on payer portal, manual adjustment to account balance and financial class changes, where relevant. Answers calls and other inquiries from payer representative timely regarding accounts and completes proper documentation of all activity on each account./ppIdentifies and communicates payment variances, error trends, and account issues for resolution to management. Identifies denial trends and reports them to management to allow for more efficient billing and timely resolution./ppReviews credit balances for adjustments, refund and/or claim adjustment submission as assigned. Researches and retrieves appropriate documentation (e.g. authorizations, medical records) for appealing denials./ppWorks correspondence as assigned and escalated by correspondence team. Communicates denials and other issues with the appropriate Revenue Cycle department and/or physician representative to address root causes./ppDocuments clear and concise notes in the billing system. Operates other relevant computer software efficiently to complete required billing and follow-up tasks./ppEnters charges into Billing System from various reports, where relevant. Performs assigned worklists and other duties quickly and accurately showing attention to details and is sufficiently organized to produce quality work./ppMaintains assigned productivity standards and escalates obstacles in accomplishing expectations in a timely manner./ppPrioritizes and updates files and other required documentation in accordance with established policies, guidelines, and procedures./ppDemonstrates willingness to adapt to changing departmental demands as new billing duties are required./ppCompletes special assignments and projects with minimal supervision and consistently meets targets./ppPerforms other duties as assigned and adapts to changing departmental demands./ph3Physical Demands and Work Environment/h3pFrequent physical demands include: Standing, Walking, Talk or Hear./ppOccasional physical demands include: Climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Squat/kneel/crawl, Wrist position deviation./ppContinuous physical demands include: Sitting, Pinching/fine motor activities, Keyboard use/repetitive motion./ppLifting Floor to Waist 20 lbs. Lifting Waist Level and Above 10 lbs./ppSensory Requirements include: Very Accurate 20/40, Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing/ppAnticipated Occupational Exposure Risks Include the following: N/A/ph3Benefits/h3pThis position is eligible for the following benefits:/pulliMedical Plan/liliPrescription drug coverage In-House Employee Pharmacy/liliDental Plan/liliVision Plan/liliFlexible Spending Account (FSA)/liliHealthcare FSA/liliDependent Care FSA/liliRetirement Savings and Investment Plan/liliBasic Group Term Life and Accidental Death Dismemberment (ADD) Insurance/liliSupplemental Group Term Life Accidental Death Dismemberment Insurance/liliDisability Benefits Long Term Disability (LTD)/liliDisability Benefits Short Term Disability (STD)/liliEmployee Assistance Program/liliCommuter Transit/liliCommuter Parking/liliSupplemental Life Insurance/liliVoluntary Life Spouse/liliVoluntary Life Employee/liliVoluntary Life Child/liliVoluntary Legal Services/liliVoluntary Accident, Critical Illness and Hospital Indemnity Insurance/liliVoluntary Identity Theft Insurance/liliVoluntary Pet Insurance/liliPaid Time-Off Program/li/ulpThe pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level./ppThe salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria./p/div