Billing Specialist

Billing Services Representative

The Billing Services Representative will:

• Ensure account accuracy.
• Review daily claims to ensure submissions are clean and timely.
• Monitor charges/modifiers/CPT-4s/HCPCS/payments/DRGs/ICD-10 coding.
• Review outstanding accounts using ATB/queues/payments reports/halt report/electronic billing edits/credit balances.
• Submit timely and accurate adjustments/notes/patient balance transfers and medical record requests.
• Work with management team and notifying of notifying of issues that arise with payors/departments/etc.
• Resolve account issues and problem solving independently whenever possible.
• Use technology provided (including hospital information system contract management system electronic billing system payer websites and document imaging system.)
• Manage denials and appealing administrative claims.
• Understand denials and how they should be handled.
• Send clinical denials and downgraded claims to appropriate parties to ensure timely appeal.
• Ensure claims denied at time of billing are distributed to appropriate parties for review.
• Update and correct accounts with assistance of originating departments (charges/authorizations/insurance issues).
• Follow departmental and hospital policy and procedure (this includes HIPAA guidelines and Federal guidelines).
• Understand payor contracts and billing guidelines revenue codes and payor specific requirements and payor/plan codes.

Requirements:

• Requires one (1) or more years experience as a Medical Insurance Biller or related responsibilities and Hospital Billing strongly preferred.
• Proficient in Microsoft Word and Microsoft Excel.
• Requires high level of interpersonal skills necessary to lead others and to work effectively with Patient Accounts Personnel as well as outside agencies.
• Must possess a comprehensive knowledge of Collection A/R follow-up and Billing. Knowledge of third-party payers State and Federal Agencies (constantly changing) with regards to Patient Accounting.
• Requires the ability to consistently meet deadlines to concentrate and pay attention to details 75 of work time.

We offer competitive base rates that are determined by many factors including job-related work experience internal equity and industry-specific market data. In addition to base salary some positions may be eligible for clinical certification pay and shift differentials.

The salary range listed for exempt positions reflects full-time compensation and will be prorated based on employment status. Saint Peter's offers a robust benefits program to eligible employees that will support you and your family in working toward achieving and maintaining secure healthy lives now and into the future. Benefits include medical dental and vision insurance savings accounts voluntary benefits wellness programs and discounts paid life insurance generous 401(k) match adoption assistance back-up daycare free onsite parking and recognition rewards.

You can take your career to the next level by participating in either a fully paid tuition program or our generous tuition assistance program. Learn more about our benefits by visiting our site at Saint Peter's.