Insurance Billing Technician I

:

30 Old Rudnick Ln

STATUS: Full Time 80 Hours

SHIFT: Days

GENERAL SUMMARY:

Summary:

Generate and submit hospital claims to third party payers and government agencies. Responsible for billing related functions for Bayhealth claims, whether electronic or hardcopy; in compliance with Federal and State regulations and established ANSI standards.

ESSENTIAL FUNCTIONS & ACCOUNTABILITIES:

1. Correct claim errors from assigned work queue(s). As needed, escalates unresolved errors to management for intervention. 2. Reviews series account and combined bill work queues and creates claims as necessary to support accurate and compliant billing. 3. Process all electronic claims on xClaim (xDirect for Medicare) resolving errors. 4. Refers complex/clinical claim errors to the correct department as needed to review and provide guidance on how the error should be resolved. Provides education to departments as needed to assist in error resolution. 5. Process electronic rejections received on submitted claims. 6. Verifies insurance eligibility to correct claim errors and/or electronic rejections and resubmits claim. 7. As needed manually enters claims/claim corrections on payer portals. 8. Submit hardcopy paper claims (including secondary and adjusted). 9. Process Medicare Shadow Billing claims as assigned. 10. Communicates new claim errors and trends to management for compliance and/or other process reviews. 11. Maintains established department productivity minimums. 12. All other duties as assigned within the scope and range of job responsibilities.

REQUIRED MINIMUM EDUCATION AND CREDENTIAL:

Education High School Diploma or GED

• Credential

EXPERIENCE:

Required: No experience required.

Preferred: One year work experience, or minimum 3 months of intern/externship of medical billing experience from a certification program.

PREFERRED EDUCATION AND CREDENTIAL:

• Education
• Credential

To view a full list of all open position at Bayhealth, please visit: